title: Impact of Obesity on Complications of Laparoscopic Simple or Radical Nephrectomy.
abstract: OBJECTIVE
  To determine the impact of obesity on complications in laparoscopic simple or radical nephrectomy.
  
  
  METHODS
  The medical files of 215 patients who underwent laparoscopic simple or radical nephrectomy in our center between 2004 and 2014 were reviewed. A body mass index of 30 kg/m² was used to divide the patients into obese and non-obese groups. Pre-operative data and intra- and post-operative complications were compared between the 2 groups.
  
  
  RESULTS
  There were respectively 163 and 52 patients in the non-obese and obese groups, which were comparable in terms of age, sex, and history of surgery. In the obese group, operative specimens were significantly heavier (772 vs. 534 g in the non-obese group; p = 0.005) and durations of surgery was significantly longer (244 vs. 216 minutes; p = 0.003). However no significant differences were found between the 2 groups for duration of hospitalization, surgical conversion, estimated blood loss, or intra- or post-operative complications.
  
  
  CONCLUSIONS
  Laparoscopic simple or radical nephrectomy is technically feasible in obese patients but the surgery may take more time, notably due to dissection difficulties. Our results showed that the risk of intra- and post-operative complications is not higher in obese patients compared to non-obese patients, except for a possible, but statistically undemonstrated, higher risk of abdominal wall complications, and that the laparoscopic approach should be the preferred technique in patients with high body mass index.
authors.affiliation: Departement of Urology, Lyon Sud University Hospital, Pierre Benite, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Arfi
authors.affiliation: Departement of Urology, Lyon Sud University Hospital, Pierre Benite, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Baldini
authors.affiliation: Departement of Anatomopathology, Lyon Sud University Hospital, Pierre Benite, France.
authors.forename: Myriam
authors.initials: M
authors.lastname: Decaussin-Petrucci
authors.affiliation: Departement of Biostatistic, Lyon Sud University Hospital, Pierre Benite, France.
authors.forename: Rene
authors.initials: R
authors.lastname: Ecochard
authors.affiliation: Departement of Urology, Lyon Sud University Hospital, Pierre Benite, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Ruffion
authors.affiliation: Departement of Urology, Lyon Sud University Hospital, Pierre Benite, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Paparel
keywords: Complications; Nephrectomy; Obesity