Influence of body mass index on postoperative outcomes after laparoscopic liver resection.
BACKGROUND
Despite the increasing prevalence of obesity, the impact of body weight on postoperative outcomes of laparoscopic liver resection (LLR) still remains poorly evaluated. The present study aimed to explore the impact of body mass index (BMI) on perioperative outcomes in patients undergoing LLR.


METHODS
All patients undergoing LLR from January 2008 to December 2013 were retrospectively reviewed. BMI was subdivided into normal weight (<24.9 kg/m(2)), overweight (25.0-29.9 kg/m(2)), and obese (≥30.0 kg/m(2)). These three groups were compared in terms of demographic data, intraoperative factors, and postoperative outcomes. Logistic regression was used to determine odds ratios with 95% confidence intervals and evaluate BMI as an independent risk factor for morbidity.


RESULTS
Among 228 selected patients, 83 (36.4%) patients were overweight and 32 (14.0%) were obese. Despite higher rates of diabetes mellitus, hypertension, and ischemic heart disease with an increase in BMI, no significant difference in operative time, blood loss, and conversion rate was observed in the three groups. There were no significant differences in postoperative mortality rate between the groups (0.9 vs. 1.2 vs. 0%). The rate of overall complications (31.0 vs. 31.3 vs. 40.6%) and major complications (14.2 vs. 9.6 vs. 18.8%) did not differ in the three groups. Major hepatectomy (HR 6.810, CI 1.437-32.267, p = 0.016) and operative time >180 min (HR 2.639, CI 1.179-5.908, p = 0.018) were independently associated with postoperative complications.


CONCLUSIONS
The present study demonstrated that BMI does not negatively affect the postoperative short-term outcomes. Therefore, obesity and overweight should not be a contraindication for LLR.
Department of Digestive Disease, Institut Mutualiste Montsouris, Université Paris-Descartes, 42 Boulevard Jourdan, 75014, Paris, France. t.nomi45@gmail.com.|Department of Surgery, Nara Medical University, 840 Shijo-cho Kashihara-shi, Nara, 634-8522, Japan. t.nomi45@gmail.com.
Takeo
T
Nomi
Department of Digestive Disease, Institut Mutualiste Montsouris, Université Paris-Descartes, 42 Boulevard Jourdan, 75014, Paris, France.
David
D
Fuks
Department of Digestive Disease, Institut Mutualiste Montsouris, Université Paris-Descartes, 42 Boulevard Jourdan, 75014, Paris, France.
Jean-Marc
JM
Ferraz
Department of Digestive Disease, Institut Mutualiste Montsouris, Université Paris-Descartes, 42 Boulevard Jourdan, 75014, Paris, France.
Yoshikuni
Y
Kawaguchi
Department of Surgery, Nara Medical University, 840 Shijo-cho Kashihara-shi, Nara, 634-8522, Japan.
Yoshiyuki
Y
Nakajima
Department of Digestive Disease, Institut Mutualiste Montsouris, Université Paris-Descartes, 42 Boulevard Jourdan, 75014, Paris, France. brice.gayet@imm.fr.
Brice
B
Gayet
D000368:Aged; D015992:Body Mass Index; D005260:Female; D005602:France / Q000453:epidemiology; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008107:Liver Diseases / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
Laparoscopy; Liver resection; Obesity; Overweight; Postoperative outcomes