title: Obesity is not associated with increased operative complications in single-site robotic partial nephrectomy.
abstract: OBJECTIVE
  To evaluate the impact of high body mass index (BMI) on outcomes following robotic laparoendoscopic single-site surgery (R-LESS) robotic-assisted laparoscopic partial nephrectomy (RPN).
  
  
  METHODS
  Data from 83 Korean patients who had undergone robotic partial nephrectomy from 2006 to 2014 were retrospectively analyzed. The subjects were stratified into two groups according to WHO definitions for the Asian population, consisting of 56 normal range (BMI=18.5-24.99 kg/m²) and 27 obese (≥25 kg/m²) patients. Outcome measurements included Trifecta achievement and the perioperative and postoperative comparison between high and normal BMI series. The measurements were estimated and analyzed with SPSS version 17.
  
  
  RESULTS
  Tumor's complexity characteristics (R.E.N.A.L. score, tumor size) of both groups were similar. No significant differences existed between the two groups with regard to operative time (p=0.27), warm ischemia time (p=0.35) estimated blood loss (p=0.42), transfusion rate (p=0.48) renal function following up for 1 year, positive margins (p=0.24) and postoperative complication rate (p=0.34). Trifecta was achieved in 5 (18.5%) obese and 19 (33.9%) normal weight patients, respectively (p=0.14). In multivariable analysis, only tumor size was significantly correlated with the possibility of Trifecta accomplishment.
  
  
  CONCLUSIONS
  Our findings suggest that R-LESS RPN can be effectively and safely performed in patients with increased BMI, since Trifecta rate, and perioperative and postoperative outcomes are not significantly different in comparison to normal weight subjects.
authors: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
authors: Christos
authors: C
authors: Komninos
authors: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
authors: Patrick
authors: P
authors: Tuliao
authors: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
authors: Kyo Chul
authors: KC
authors: Koo
authors: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
authors: Chien-Hsiang
authors: CH
authors: Chang
authors: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
authors: Woong Kyu
authors: WK
authors: Han
authors: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea. khrha@yuhs.ac.
authors: Koon Ho
authors: KH
authors: Rha
mesh_terms: D000328:Adult; D001803:Blood Transfusion; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D009765:Obesity / Q000150:complications*; D061646:Operative Time; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D056910:Republic of Korea; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D012371:Robotics; D016896:Treatment Outcome; D052096:Warm Ischemia
keywords: Body mass index; partial nephrectomy; robotic surgery