Evaluation of the impact of body mass index on outcome among renal mass patients treated with hand-assisted laparoscopic radical nephrectomy

Alexander Parker, Richard Lewis, Michael G. Heckman, Nancy H. Diehl, Theodore Brisson, Raymond Pak, Michael J. Wehle

Research output: Contribution to journalArticle

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Abstract

Purpose: Although there are empiric data to show that obesity is not a contraindication for laparoscopic radical nephrectomy, similar data are lacking for the use of hand-assisted laparoscopic radical nephrectomy (HALRN) in obese patients. We evaluate whether obese patients undergoing HALRN to manage a renal mass are more likely than nonobese patients to experience poor intraoperative and perioperative outcomes. Patients and Methods: Between June 1, 1999, and May 31, 2006, 150 patients underwent HALRN for the management of a solid renal mass at our institution. We abstracted detailed demographic, clinical, and follow-up data on all patients in this cohort. As our primary analysis, we evaluated associations between body mass index (BMI) and estimated blood loss, operative time, length of stay, and complications using linear and logistic regression models. Results: There was no evidence that obese patients experienced a statistically significant or clinically relevant increase in blood loss (P = 0.97), operative times (P = 0.87) or length of stay (P = 0.62) compared with persons of normal weight. In contrast, although there was no evidence of a linear trend toward complications in patients with a higher BMI (P = 0.19), obese patients were almost three times more likely to experience a complication compared with normal-weight persons (odds ratio 2.88; 95% confidence interval 1.01-8.16). Adjusting for relevant clinical covariates individually did not markedly alter these associations. Conclusions: Obesity is not a contraindication for HALRN to manage a renal mass; however, obese patients should be aware that they may be at increased risk for certain complications after surgery, notably ileus and incisional hernias.

Original languageEnglish (US)
Pages (from-to)301-306
Number of pages6
JournalJournal of Endourology
Volume22
Issue number2
DOIs
StatePublished - Feb 1 2008

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Nephrectomy
Body Mass Index
Hand
Kidney
Operative Time
Length of Stay
Obesity
Logistic Models
Weights and Measures
Ileus
Linear Models
Odds Ratio
Demography
Confidence Intervals

ASJC Scopus subject areas

  • Urology

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Evaluation of the impact of body mass index on outcome among renal mass patients treated with hand-assisted laparoscopic radical nephrectomy. / Parker, Alexander; Lewis, Richard; Heckman, Michael G.; Diehl, Nancy H.; Brisson, Theodore; Pak, Raymond; Wehle, Michael J.

In: Journal of Endourology, Vol. 22, No. 2, 01.02.2008, p. 301-306.

Research output: Contribution to journalArticle

Parker, Alexander ; Lewis, Richard ; Heckman, Michael G. ; Diehl, Nancy H. ; Brisson, Theodore ; Pak, Raymond ; Wehle, Michael J. / Evaluation of the impact of body mass index on outcome among renal mass patients treated with hand-assisted laparoscopic radical nephrectomy. In: Journal of Endourology. 2008 ; Vol. 22, No. 2. pp. 301-306.
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