title: Effect of Obesity on Perioperative Outcomes After Robotic-Assisted Pulmonary Lobectomy.
abstract: OBJECTIVE
  We investigated whether higher body mass index (BMI) affects perioperative and postoperative outcomes after robotic-assisted video-thoracoscopic pulmonary lobectomy.
  
  
  METHODS
  We retrospectively studied all patients who underwent robotic-assisted pulmonary lobectomy by one surgeon between September 2010 and January 2015. Patients were grouped according to the World Health Organization's definition of obesity, with "obese" being defined as BMI >30.0 kg/m2. Perioperative outcomes, including intraoperative estimated blood loss (EBL) and postoperative complication rates, were compared.
  
  
  RESULTS
  Over 53 months, 287 patients underwent robotic-assisted pulmonary lobectomy, with 7 patients categorized as "underweight," 94 patients categorized as "normal weight," 106 patients categorized as "overweight," and 80 patients categorized as "obese." Because of the relatively low sample size, "underweight" patients were excluded from this study, leaving a total cohort of 280 patients. There was no significant difference in intraoperative complication rates, conversion rates, perioperative outcomes, or postoperative complication rates among the 3 groups, except for lower risk of prolonged air leaks ≥7 days and higher risk of pneumonia in patients with obesity.
  
  
  CONCLUSIONS
  Patients with obesity do not have increased risk of intraoperative or postoperative complications, except for pneumonia, compared with "normal weight" and "overweight" patients. Robotic-assisted pulmonary lobectomy is safe and effective for patients with high BMI.
authors.affiliation: 1 University of South Florida, Tampa, FL, USA.
authors.forename: Bryce
authors.initials: B
authors.lastname: Montané
authors.affiliation: 1 University of South Florida, Tampa, FL, USA.
authors.forename: Kavian
authors.initials: K
authors.lastname: Toosi
authors.affiliation: 1 University of South Florida, Tampa, FL, USA.
authors.forename: Frank O
authors.initials: FO
authors.lastname: Velez-Cubian
authors.affiliation: 1 University of South Florida, Tampa, FL, USA.
authors.forename: Maria F
authors.initials: MF
authors.lastname: Echavarria
authors.affiliation: 1 University of South Florida, Tampa, FL, USA.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Thau
authors.affiliation: 1 University of South Florida, Tampa, FL, USA.
authors.forename: Raj A
authors.initials: RA
authors.lastname: Patel
authors.affiliation: 1 University of South Florida, Tampa, FL, USA.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Rodriguez
authors.affiliation: 2 Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: Carla C
authors.initials: CC
authors.lastname: Moodie
authors.affiliation: 2 Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Garrett
authors.affiliation: 1 University of South Florida, Tampa, FL, USA.|2 Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: Jacques P
authors.initials: JP
authors.lastname: Fontaine
authors.affiliation: 1 University of South Florida, Tampa, FL, USA.|2 Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Toloza
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology*; D008168:Lung / Q000601:surgery; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D011013:Pneumonectomy / Q000009:adverse effects / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data*
keywords: body mass index (BMI); lobectomy; lung cancer; minimal invasive surgery; robotic