Impact of body mass index on the difficulty and outcomes of laparoscopic left lateral sectionectomy.

Humans Body Mass Index Retrospective Studies Length of Stay Hepatectomy / methods Laparoscopy / methods Operative Time Liver Neoplasms / surgery Treatment Outcome Postoperative Complications / etiology

Body mass index Laparoscopic hepatectomy Laparoscopic liver Left lateral sectionectomy Minimally-invasive hepatectomy Minimally-invasive liver

Journal

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

ISSN: 1532-2157

Titre abrégé: Eur J Surg Oncol

Pays: England

ID NLM: 8504356

Informations de publication

Date de publication:
08 2023

Historique:

received: 25 01 2023

revised: 19 03 2023

accepted: 30 03 2023

medline: 9 8 2023

pubmed: 16 5 2023

entrez: 15 5 2023

Statut: ppublish

Résumé

Currently, the impact of body mass index (BMI) on the outcomes of laparoscopic liver resections (LLR) is poorly defined. This study attempts to evaluate the impact of BMI on the peri-operative outcomes following laparoscopic left lateral sectionectomy (L-LLS). A retrospective analysis of 2183 patients who underwent pure L-LLS at 59 international centers between 2004 and 2021 was performed. Associations between BMI and selected peri-operative outcomes were analyzed using restricted cubic splines. A BMI of >27kg/m2 was associated with increased in blood loss (Mean difference (MD) 21 mls, 95% CI 5-36), open conversions (Relative risk (RR) 1.13, 95% CI 1.03-1.25), operative time (MD 11 min, 95% CI 6-16), use of Pringles maneuver (RR 1.15, 95% CI 1.06-1.26) and reductions in length of stay (MD -0.2 days, 95% CI -0.3 to -0.1). The magnitude of these differences increased with each unit increase in BMI. However, there was a "U" shaped association between BMI and morbidity with the highest complication rates observed in underweight and obese patients. Increasing BMI resulted in increasing difficulty of L-LLS. Consideration should be given to its incorporation in future difficulty scoring systems in laparoscopic liver resections.

Identifiants

DOI: 10.1016/j.ejso.2023.03.235 PMID: 37188553

pubmed: 37188553

pii: S0748-7983(23)00435-3

doi: 10.1016/j.ejso.2023.03.235

pii:

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

1466-1473

Investigateurs

Mikel Gastaca (M)

Juul Meurs (J)

Celine De Meyere (C)

Kit-Fai Lee (KF)

Kelvin K Ng (KK)

Diana Salimgereeva (D)

Ruslan Alikhanov (R)

Lip-Seng Lee (LS)

Jae-Young Jang (JY)

Masayuki Kojima (M)

Jaime Arthur Pirola Kruger (JA)

Fabricio Ferreira Coelho (FF)

Victor Lopez-Lopez (V)

Margarida Casellas I Robert (M)

Roberto Montalti (R)

Mariano Giglio (M)

Mizelle D'Silva (M)

Boram Lee (B)

Hao-Ping Wang (HP)

Franco Pascual (F)

Mansour Saleh (M)

Simone Vani (S)

Francesco Ardito (F)

Ugo Giustizieri (U)

Davide Citterio (D)

Federico Mocchegiani (F)

Giammauro Berardi (G)

Marco Colasanti (M)

Yoelimar Guzmán (Y)

Kevin P Labadie (KP)

Maria Conticchio (M)

Epameinondas Dogeas (E)

Emanuele F Kauffmann (EF)

Mario Giuffrida (M)

Daniele Sommacale (D)

Alexis Laurent (A)

Paolo Magistri (P)

Kohei Mishima (K)

Moritz Schmelzle (M)

Felix Krenzien (F)

Prashant Kadam (P)

Eric C H Lai (ECH)

Jacob Ghotbi (J)

Åsmund Avdem Fretland (ÅA)

Fabio Forchino (F)

Alessandro Mazzotta (A)

Francois Cauchy (F)

Chetana Lim (C)

Bernardo Dalla Valle (BD)

Junhao Zheng (J)

Phan Phuoc Nghia (PP)