title: Obesity does not adversely affect outcomes after laparoscopic splenectomy.
abstract: BACKGROUND
  Obesity is still considered a relative contraindication to laparoscopic splenectomy (LS).
  
  
  METHODS
  All patients undergoing LS at our institution were classified as obese or nonobese (group A, body mass index [BMI] >30; group B, BMI <30). Primary end points included conversion rate, operative complications, length of stay, operative time, and estimated blood loss (EBL).
  
  
  RESULTS
  Three hundred seventy patients who underwent LS were included. Baseline characteristics were similar in groups A (n = 127; mean BMI, 36.2 ± 6.9 kg/m²) and B (n = 243; mean BMI, 24.6 ± 2.9 kg/m²). Conversion rates and overall morbidity were similar in both groups (9% vs 11% for conversion to open procedures, P = .621; 16% vs 16% for morbidity rates, P = .940). Length of hospital stay and EBL were also comparable (P = .643 and P = .544, respectively). Mean operative time was significantly increased in the obese group on multivariate analysis (170 vs 151 minutes, P = .021).
  
  
  CONCLUSIONS
  Obesity does not adversely affect outcomes after LS. The laparoscopic approach is the optimal technique for splenectomy regardless of the patient's weight.
authors: Department of Minimally Invasive Surgery, Bariatric and Metabolic Institute, M61, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA. heneghh@ccf.org
authors: Helen M
authors: HM
authors: Heneghan
authors: Shohrat
authors: S
authors: Annaberdyev
authors: Vikram
authors: V
authors: Attaluri
authors: Tracy
authors: T
authors: Pitt
authors: Matthew
authors: M
authors: Kroh
authors: Sri
authors: S
authors: Chalikonda
authors: Stacy A
authors: SA
authors: Brethauer
authors: Steven
authors: S
authors: Rosenblatt
mesh_terms: D000328:Adult; D000368:Aged; D000744:Anemia, Hemolytic, Autoimmune / Q000601:surgery; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology; D061887:Conversion to Open Surgery; D005240:Feasibility Studies; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007239:Infections / Q000209:etiology; D010535:Laparoscopy / Q000009:adverse effects*; D007902:Length of Stay; D008232:Lymphoproliferative Disorders / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D061646:Operative Time; D009929:Organ Size; D010179:Pancreas / Q000293:injuries; D011183:Postoperative Complications / Q000209:etiology*; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000601:surgery; D012140:Respiratory Tract Diseases / Q000209:etiology; D012189:Retrospective Studies; D013154:Spleen / Q000473:pathology* / Q000601:surgery; D013156:Splenectomy / Q000009:adverse effects* / Q000379:methods* / Q000401:mortality; D013163:Splenomegaly / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome