TY - JOUR
T1 - Impact of body mass index on the difficulty and outcomes of laparoscopic left lateral sectionectomy
AU - International robotic and laparoscopic liver resection study group investigators are coauthors of this study
AU - Chen, Zewei
AU - Yin, Mengqiu
AU - Fu, Junhao
AU - Yu, Shian
AU - Syn, Nicholas L.
AU - Chua, Darren W.
AU - Kingham, T. Peter
AU - Zhang, Wanguang
AU - Hoogteijling, Tijs J.
AU - Aghayan, Davit L.
AU - Siow, Tiing Foong
AU - Scatton, Olivier
AU - Herman, Paulo
AU - Marino, Marco V.
AU - Mazzaferro, Vincenzo
AU - Chiow, Adrian K. H.
AU - Sucandy, Iswanto
AU - Ivanecz, Arpad
AU - Choi, Sung Hoon
AU - Lee, Jae Hoon
AU - Prieto, Mikel
AU - Vivarelli, Marco
AU - Giuliante, Felice
AU - Ruzzenente, Andrea
AU - Yong, Chee-Chien
AU - Dokmak, Safi
AU - Fondevila, Constantino
AU - Efanov, Mikhail
AU - Morise, Zenichi
AU - di Benedetto, Fabrizio
AU - Brustia, Raffaele
AU - Dalla Valle, Raffaele
AU - Boggi, Ugo
AU - Geller, David
AU - Belli, Andrea
AU - Memeo, Riccardo
AU - Gruttadauria, Salvatore
AU - Mejia, Alejandro
AU - Park, James O.
AU - Rotellar, Fernando
AU - Choi, Gi-Hong
AU - Robles-Campos, Ricardo
AU - Wang, Xiaoying
AU - Sutcliffe, Robert P.
AU - Pratschke, Johann
AU - Lai, Eric C. H.
AU - Chong, Charing C. N.
AU - D'Hondt, Mathieu
AU - Monden, Kazuteru
AU - Lopez-Ben, Santiago
N1 - Funding Information: Dr S. Yu was partially funded by the Research Project of Zhejiang Provincial Public Welfare Fund project in the Field of Social development ( LGF20H160028 ). Funding Information: Dr Brian K. P. Goh was partially supported by a grant from the Intuitive Foundation for this study. All research findings, conclusions or recommendations expressed in this work are those of the authors and not of the Intuitive Foundation. Funding Information: Dr T. P. Kingham was partially supported by the US National Cancer Institute MSKCC Core Grant number P30 CA008747 for this study. Publisher Copyright: © 2023 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology
PY - 2023/8/1
Y1 - 2023/8/1
N2 - 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.
AB - 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.
KW - Body mass index
KW - Laparoscopic hepatectomy
KW - Laparoscopic liver
KW - Left lateral sectionectomy
KW - Minimally-invasive hepatectomy
KW - Minimally-invasive liver
UR - http://www.scopus.com/inward/record.url?scp=85160584967&partnerID=8YFLogxK
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85160584967&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/37188553
U2 - https://doi.org/10.1016/j.ejso.2023.03.235
DO - https://doi.org/10.1016/j.ejso.2023.03.235
M3 - Article
C2 - 37188553
SN - 0748-7983
VL - 49
SP - 1466
EP - 1473
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 8
ER -