Robot-Assisted Partial Nephrectomy in Obese Patients

摘要

PURPOSE: To report our experience with robot-assisted partial nephrectomy (RAPN) in obese patients compared with a contemporary cohort of nonobese patients. PATIENTS AND METHODS: We defined obesity as a body mass index (BMI) ≥ 30 kg/m(2). From June 2004 to September 2009, 97 patients underwent RAPN at our institution, of whom 49 were obese (group 1) and 48 were nonobese (group 2, BMI <30 kg/m(2)). We compared demographics, operative data, complications, and pathological outcomes between these two groups. RESULTS: The average BMI for the obese group was 36.2 kg/m(2) (range 30.3-49) compared with 25.7 kg/m(2) (range 20.5-29.7) for the nonobese group. Median tumor size was 2.5 versus 2.3 cm for obese and nonobese groups, respectively. Obese patients had a larger median estimated blood loss (150 vs.100 mL, p=0.027) and a trend toward a longer median operative time (265 vs. 242.5 minutes, p=0.085) and median warm ischemia time (26.5 vs. 22.5 minutes, p=0.074), but this did not achieve statistical significance. An intraoperative complication occurred in one patient in each group. The postoperative complication rate was not statistically significant between the two groups (8.3% vs. 4.3%, p=0.377). The median hospital stay was 2 days for both groups. CONCLUSIONS: RAPN is safe and feasible in obese patients. Obese patients had a higher estimated blood loss and a trend toward greater operative time and warm ischemia time, which did not achieve statistical significance.