Impact of body mass index on perioperative outcomes of laparoscopic major hepatectomies Journal Article
| Authors: | Berardi, G.; Kingham, T. P.; Zhang, W.; Syn, N. L.; Koh, Y. X.; Jaber, B.; Aghayan, D. L.; Siow, T. F.; Lim, C.; Scatton, O.; Herman, P.; Coelho, F. F.; Marino, M. V.; Mazzaferro, V.; Chiow, A. K. H.; Sucandy, I.; Ivanecz, A.; Choi, S. H.; Lee, J. H.; Gastaca, M.; Vivarelli, M.; Giuliante, F.; Dalla Valle, B.; Ruzzenente, A.; Yong, C. C.; Chen, Z.; Yin, M.; 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.; Schmelzle, M.; Pratschke, J.; Lai, E. C. H.; Chong, C. C. N.; Meurs, J.; D'Hondt, M.; Monden, K.; Lopez-Ben, S.; Liu, Q.; Liu, R.; Ferrero, A.; Ettorre, G. M.; Cipriani, F.; Pascual, F.; Cherqui, D.; Zheng, J.; Liang, X.; Soubrane, O.; Wakabayashi, G.; Troisi, R. I.; Cheung, T. T.; Kato, Y.; Sugioka, A.; D'Silva, M.; Han, H. S.; Nghia, P. P.; Long, T. C. D.; Edwin, B.; Fuks, D.; Abu Hilal, M.; Aldrighetti, L.; Chen, K. H.; Impact of body mass index on perioperative outcomes of laparoscopic major hepatectomies |
| Article Title: | Impact of body mass index on perioperative outcomes of laparoscopic major hepatectomies |
| Abstract: | Background: Data on the effect of body mass index on laparoscopic liver resections are conflicting. We performed this study to investigate the association between body mass index and postoperative outcomes after laparoscopic major hepatectomies. Methods: This is a retrospective review of 4,348 laparoscopic major hepatectomies at 58 centers between 2005 and 2021, of which 3,383 met the study inclusion criteria. Concomitant major operations, vascular resections, and previous liver resections were excluded. Associations between body mass index and perioperative outcomes were analyzed using restricted cubic splines. Modeled effect sizes were visually rendered and summarized. Results: A total of 1,810 patients (53.5%) had normal weight, whereas 1,057 (31.2%) were overweight and 392 (11.6%) were obese. One hundred and twenty-four patients (3.6%) were underweight. Most perioperative outcomes showed a linear worsening trend with increasing body mass index. There was a statistically significant increase in open conversion rate (16.3%, 10.8%, 9.2%, and 5.6%, P <.001), longer operation time (320 vs 305 vs 300 and 266 minutes, P <.001), increasing blood loss (300 vs 300 vs 295 vs 250 mL, P =.022), and higher postoperative morbidity (33.4% vs 26.3% vs 25.0% vs 25.0%, P =.009) in obese, overweight, normal weight, and underweight patients, respectively (P <.001). However, postoperative major morbidity demonstrated a “U”-shaped association with body mass index, whereby the highest major morbidity rates were observed in underweight and obese patients. Conclusion: Laparoscopic major hepatectomy was associated with poorer outcomes with increasing body mass index for most perioperative outcome measures. © 2023 Elsevier Inc. |
| Keywords: | adult; treatment outcome; aged; retrospective studies; major clinical study; postoperative period; laparoscopy; laparoscopic surgery; disease association; bleeding; morbidity; obesity; overweight; retrospective study; postoperative complication; postoperative complications; length of stay; body mass; body mass index; hepatectomy; perioperative period; underweight; complication; humans; human; male; female; article; thinness |
| Journal Title: | Surgery |
| Volume: | 174 |
| Issue: | 2 |
| ISSN: | 0039-6060 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2023-08-01 |
| Start Page: | 259 |
| End Page: | 267 |
| Language: | English |
| DOI: | 10.1016/j.surg.2023.04.016 |
| PUBMED: | 37271685 |
| PROVIDER: | scopus |
| PMCID: | PMC10832351 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF. Corresponding MSK author T. Peter Kingham -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work