Impact of body mass index on the difficulty and outcomes of laparoscopic left lateral sectionectomy Journal Article
| Authors: | Chen, Z.; Yin, M.; Fu, J.; Yu, S.; Syn, N. L.; Chua, D. W.; Kingham, T. P.; Zhang, W.; Hoogteijling, T. J.; Aghayan, D. L.; Siow, T. F.; Scatton, O.; Herman, P.; Marino, M. V.; Mazzaferro, V.; Chiow, A. K. H.; Sucandy, I.; Ivanecz, A.; Choi, S. H.; Lee, J. H.; Prieto, M.; Vivarelli, M.; Giuliante, F.; Ruzzenente, A.; Yong, C. C.; 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, J. O.; Rotellar, F.; Choi, G. H.; Robles-Campos, R.; Wang, X.; Sutcliffe, R. P.; Pratschke, J.; Lai, E. C. H.; Chong, C. C. N.; D'Hondt, M.; Monden, K.; Lopez-Ben, S.; Liu, Q.; Liu, R.; Ferrero, A.; Ettorre, G. M.; Cipriani, F.; Cherqui, D.; Liang, X.; Soubrane, O.; Wakabayashi, G.; Troisi, R. I.; Cheung, T. T.; Kato, Y.; Sugioka, A.; Han, H. S.; Long, T. C. D.; Fuks, D.; Abu Hilal, M.; Aldrighetti, L.; Chen, K. H.; Edwin, B.; Goh, B. K. P. |
| Article Title: | Impact of body mass index on the difficulty and outcomes of laparoscopic left lateral sectionectomy |
| 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. © 2023 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology |
| Keywords: | adult; treatment outcome; aged; retrospective studies; major clinical study; liver neoplasms; outcome assessment; laparoscopy; laparoscopic surgery; morbidity; cohort analysis; obesity; medical record review; retrospective study; risk factor; postoperative complication; postoperative complications; length of stay; body mass; body mass index; liver tumor; operation duration; hepatectomy; perioperative period; postoperative hemorrhage; underweight; complication; procedures; open surgery; operative time; humans; human; male; female; article; laparoscopic hepatectomy; obese patient; laparoscopic liver; left lateral sectionectomy; minimally-invasive hepatectomy; minimally-invasive liver; laparoscopic left lateral sectionectomy; pringles maneuver |
| Journal Title: | European Journal of Surgical Oncology |
| Volume: | 49 |
| Issue: | 8 |
| ISSN: | 0748-7983 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2023-08-01 |
| Start Page: | 1466 |
| End Page: | 1473 |
| Language: | English |
| DOI: | 10.1016/j.ejso.2023.03.235 |
| PUBMED: | 37188553 |
| PROVIDER: | scopus |
| PMCID: | PMC10979757 |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
