Impact of body mass index on the difficulty and outcomes of laparoscopic left lateral sectionectomy.
Chen, Zewei Yin, Mengqiu Fu, Junhao Yu, Shian Syn, Nicholas L Chua, Darren W Kingham, T Peter Zhang, Wanguang Hoogteijling, Tijs J Aghayan, Davit L
Chen, Zewei
Yin, Mengqiu
Fu, Junhao
Yu, Shian
Syn, Nicholas L
Chua, Darren W
Kingham, T Peter
Zhang, Wanguang
Hoogteijling, Tijs J
Aghayan, Davit L
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2023-05-03
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Abstract
Introduction: 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).
Methods: 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.
Results: 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.
Conclusion: 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.
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Chen Z, Yin M, Fu J, Yu S, Syn NL, Chua DW, Kingham TP, Zhang W, Hoogteijling TJ, Aghayan DL, Siow TF, Scatton O, Herman P, Marino MV, Mazzaferro V, Chiow AKH, Sucandy I, Ivanecz A, Choi SH, Lee JH, Prieto M, Vivarelli M, Giuliante F, Ruzzenente A, Yong CC, Dokmak S, Fondevila C, Efanov M, Morise Z, Di Benedetto F, Brustia R, Dalla Valle R, Boggi U, Geller D, Belli A, Memeo R, Gruttadauria S, Mejia A, Park JO, Rotellar F, Choi GH, Robles-Campos R, Wang X, Sutcliffe RP, Pratschke J, Lai ECH, Chong CCN, D'Hondt M, Monden K, Lopez-Ben S, Liu Q, Liu R, Ferrero A, Ettorre GM, Cipriani F, Cherqui D, Liang X, Soubrane O, Wakabayashi G, Troisi RI, Cheung TT, Kato Y, Sugioka A, Han HS, Long TCD, Fuks D, Abu Hilal M, Aldrighetti L, Chen KH, Edwin B, Goh BKP; International robotic and laparoscopic liver resection study group investigators are coauthors of this study. Impact of body mass index on the difficulty and outcomes of laparoscopic left lateral sectionectomy. Eur J Surg Oncol. 2023 Aug;49(8):1466-1473. doi: 10.1016/j.ejso.2023.03.235. Epub 2023 May 3. PMID: 37188553.
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