The safety and efficacy of laparoscopic hepatectomy in obese patients.
Adult
Aged
Aged, 80 and over
Blood Loss, Surgical
/ statistics & numerical data
Blood Transfusion
/ statistics & numerical data
Female
Hepatectomy
/ methods
Humans
Intraoperative Care
Laparoscopy
/ methods
Length of Stay
/ statistics & numerical data
Liver Cirrhosis
/ epidemiology
Male
Margins of Excision
Middle Aged
Obesity
Operative Time
Postoperative Complications
/ epidemiology
Retrospective Studies
Risk
Safety
Time Factors
Laparoscopic hepatectomy
Laparoscopic liver resection
Obesity
Journal
Asian journal of surgery
ISSN: 0219-3108
Titre abrégé: Asian J Surg
Pays: Netherlands
ID NLM: 8900600
Informations de publication
Date de publication:
Jan 2019
Jan 2019
Historique:
received:
09
09
2017
revised:
09
10
2017
accepted:
30
10
2017
pubmed:
24
12
2017
medline:
9
4
2019
entrez:
24
12
2017
Statut:
ppublish
Résumé
Obesity is generally reported to increase the risk of surgical complications. There have been few reports of laparoscopic hepatectomy (LH) in obese patients. The purpose of this study was to compare the safety and efficacy of (1) LH versus open hepatectomy (OH) in obese patients and (2) LH in obese patients versus LH in non-obese patients. We introduced LH at our institution in April 2014. LH was performed in 63 obese patients and 108 non-obese patients from April 2014 to May 2017. OH was performed in 79 obese patients from January 2010 to May 2017. This study retrospectively compared the short-term outcomes of the LH obese group with those of the OH obese group and the LH non-obese group. In patient characteristics, the LH obese group included a significantly higher percentage of patients with liver cirrhosis than the OH obese group. The LH obese group had fewer patients with a history of abdominal surgery but more with liver cirrhosis than the LH non-obese group. For short-term outcomes, the LH obese group had significantly less blood loss, fewer intraoperative transfusions, fewer positive surgical margins, and shorter postoperative hospital stays than the OH obese group. In contrast, only operation time was significantly different (longer) in the LH obese group than in the LH non-obese group. There were no significant differences in morbidity or mortality between the LH obese group and either the OH obese or the LH non-obese groups. LH in obese patients is safe and effective.
Sections du résumé
BACKGROUND
BACKGROUND
Obesity is generally reported to increase the risk of surgical complications. There have been few reports of laparoscopic hepatectomy (LH) in obese patients. The purpose of this study was to compare the safety and efficacy of (1) LH versus open hepatectomy (OH) in obese patients and (2) LH in obese patients versus LH in non-obese patients.
METHODS
METHODS
We introduced LH at our institution in April 2014. LH was performed in 63 obese patients and 108 non-obese patients from April 2014 to May 2017. OH was performed in 79 obese patients from January 2010 to May 2017. This study retrospectively compared the short-term outcomes of the LH obese group with those of the OH obese group and the LH non-obese group.
RESULTS
RESULTS
In patient characteristics, the LH obese group included a significantly higher percentage of patients with liver cirrhosis than the OH obese group. The LH obese group had fewer patients with a history of abdominal surgery but more with liver cirrhosis than the LH non-obese group. For short-term outcomes, the LH obese group had significantly less blood loss, fewer intraoperative transfusions, fewer positive surgical margins, and shorter postoperative hospital stays than the OH obese group. In contrast, only operation time was significantly different (longer) in the LH obese group than in the LH non-obese group. There were no significant differences in morbidity or mortality between the LH obese group and either the OH obese or the LH non-obese groups.
CONCLUSION
CONCLUSIONS
LH in obese patients is safe and effective.
Identifiants
pubmed: 29273265
pii: S1015-9584(17)30479-7
doi: 10.1016/j.asjsur.2017.10.002
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
180-188Informations de copyright
Copyright © 2017. Published by Elsevier Taiwan LLC.