title: The impact of stapling devices use on patients with increased body mass index treated with radical cystectomy.
abstract: BACKGROUND
  The aim of this retrospective study was to evaluate the impact of stapling devices use on overweight and obese bladder cancer patients treated with radical cystectomy (RC).
  
  
  METHODS
  Fifty-two overweight and 24 obese patients underwent open RC for muscle invasive bladder cancer. Bladder removal was performed using standard suture technique (SST) or multifire autosuture articulated vascular Endo-GIA (eG). Twenty-three overweight and 11 obese patients formed the SST arms and the remaining 29 overweight and 13 obese patients formed the eG arms. Intra and postoperative parameters and early postoperative complications (30 days) using the Clavien-Dindo classification were recorded.
  
  
  RESULTS
  SST and eG arms of overweight and obese patients were comparable in intra and postoperative parameters. Both overweight and obese eG arms had significantly lower estimated blood loss, lower number of transfused packed red blood cells units (PRBC) and lower cystectomy intraoperative time compared with the SST ones (p < 0.05). In obese patients, staplers use led to significantly lower total length of stay compared with SST (p = 0.041). Complications rate was significantly higher in the obese group compared with the overweight group (58.33% versus 30.77%, p = 0.042). No difference in complications was found between the SST and eG arms of the overweight and obese patients. No deaths occurred.
  
  
  CONCLUSIONS
  Staplers use in RC in overweight/obese patients is accompanied by significantly shorter intraoperative time, lower blood loss and lower number of transfused PRBC units, compared with SST. In obese patients, eG use led to shorter length of stay.
authors: University of Thessaly, School of Health Sciences, Faculty of Medicine, Larissa, Greece.
authors: Vassilios
authors: V
authors: Tzortzis
authors: Konstantinos
authors: K
authors: Dimitropoulos
authors: Stavros
authors: S
authors: Gravas
authors: Anastasios
authors: A
authors: Karatzas
authors: Ioannis
authors: I
authors: Zachos
authors: Ioannis
authors: I
authors: Gkialas
authors: Georgios
authors: G
authors: Papadopoulos
authors: Michael
authors: M
authors: Melekos
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D015992:Body Mass Index; D015653:Cystectomy / Q000009:adverse effects* / Q000295:instrumentation*; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D045823:Ileus / Q000209:etiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D061646:Operative Time; D010149:Postoperative Pain / Q000209:etiology; D012189:Retrospective Studies; D013528:Surgical Staplers; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D001749:Urinary Bladder Neoplasms / Q000601:surgery*