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Laparoscopic hepatectomy reduces postoperative complications and hospital stay in overweight and obese patients
BACKGROUND: Laparoscopic liver surgery is currently considered the standard of care for various liver malignancies. However, studies focusing on perioperative outcome after laparoscopic hepatectomy (LH) in overweight patients are still sparse and its benefit compared to open hepatectomy (OH) is a ma...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7830078/ https://www.ncbi.nlm.nih.gov/pubmed/33552392 http://dx.doi.org/10.4240/wjgs.v13.i1.19 |
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author | Heise, Daniel Bednarsch, Jan Kroh, Andreas Schipper, Sandra Eickhoff, Roman Coolsen, Marielle Van Dam, Ronald Lang, Sven Neumann, Ulf Ulmer, Florian |
author_facet | Heise, Daniel Bednarsch, Jan Kroh, Andreas Schipper, Sandra Eickhoff, Roman Coolsen, Marielle Van Dam, Ronald Lang, Sven Neumann, Ulf Ulmer, Florian |
author_sort | Heise, Daniel |
collection | PubMed |
description | BACKGROUND: Laparoscopic liver surgery is currently considered the standard of care for various liver malignancies. However, studies focusing on perioperative outcome after laparoscopic hepatectomy (LH) in overweight patients are still sparse and its benefit compared to open hepatectomy (OH) is a matter of debate. AIM: To analyze postoperative outcomes in overweight [body mass index (BMI) over 25 kg/m²] and obese (BMI over 30 kg/m²) patients undergoing LH and compare postoperative outcome with patients undergoing OH. METHODS: Perioperative data of 68 overweight (BMI over 25 kg/m²) including a subcohort of obese (BMI over 30 kg/m²) patients (n = 27) who underwent LH at our institution between 2015 and 2019 were retrospectively analyzed regarding surgical outcome and compared to an equal number of patients undergoing OH. RESULTS: The mean BMI was 29.8 ± 4.9 kg/m(2) in the LH group and 29.7 ± 3.6 kg/m(2) in the OH group with major resections performed in 20.6% (LH) and 26.5% (OH) of cases, respectively. Operative time (194 ± 88 min vs 275 ± 131 min; P < 0.001) as well as intensive care (0.8 ± 0.7 d vs 1.1 ± 0.8 d; P = 0.031) and hospital stay (7.3 ± 3.6 d vs 15.7 ± 13.5 d; P < 0.001) were significant shorter in the LH group. Also, overall complications (20.6% vs 45.6%; P = 0.005) and major complications (1.5% vs 14.7%, P = 0.002) were observed less frequently after LH. An additional investigation analyzing the subgroup of obese patients who underwent LH (n = 27) and OH (n = 29) showed a shorter operative time (194 ± 81 min vs 260 ± 137 min; P = 0.009) and a reduced length of hospitalization (7.7 ± 4.3 d vs 17.2 ± 17 d; P < 0.001) but no difference in postoperative complications or overall cost. CONCLUSION: LH is safe and cost-effective in overweight and obese patients. Furthermore, LH is significantly associated with fewer postoperative complications and reduced hospital stay compared to OH in these patients. |
format | Online Article Text |
id | pubmed-7830078 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-78300782021-02-04 Laparoscopic hepatectomy reduces postoperative complications and hospital stay in overweight and obese patients Heise, Daniel Bednarsch, Jan Kroh, Andreas Schipper, Sandra Eickhoff, Roman Coolsen, Marielle Van Dam, Ronald Lang, Sven Neumann, Ulf Ulmer, Florian World J Gastrointest Surg Retrospective Cohort Study BACKGROUND: Laparoscopic liver surgery is currently considered the standard of care for various liver malignancies. However, studies focusing on perioperative outcome after laparoscopic hepatectomy (LH) in overweight patients are still sparse and its benefit compared to open hepatectomy (OH) is a matter of debate. AIM: To analyze postoperative outcomes in overweight [body mass index (BMI) over 25 kg/m²] and obese (BMI over 30 kg/m²) patients undergoing LH and compare postoperative outcome with patients undergoing OH. METHODS: Perioperative data of 68 overweight (BMI over 25 kg/m²) including a subcohort of obese (BMI over 30 kg/m²) patients (n = 27) who underwent LH at our institution between 2015 and 2019 were retrospectively analyzed regarding surgical outcome and compared to an equal number of patients undergoing OH. RESULTS: The mean BMI was 29.8 ± 4.9 kg/m(2) in the LH group and 29.7 ± 3.6 kg/m(2) in the OH group with major resections performed in 20.6% (LH) and 26.5% (OH) of cases, respectively. Operative time (194 ± 88 min vs 275 ± 131 min; P < 0.001) as well as intensive care (0.8 ± 0.7 d vs 1.1 ± 0.8 d; P = 0.031) and hospital stay (7.3 ± 3.6 d vs 15.7 ± 13.5 d; P < 0.001) were significant shorter in the LH group. Also, overall complications (20.6% vs 45.6%; P = 0.005) and major complications (1.5% vs 14.7%, P = 0.002) were observed less frequently after LH. An additional investigation analyzing the subgroup of obese patients who underwent LH (n = 27) and OH (n = 29) showed a shorter operative time (194 ± 81 min vs 260 ± 137 min; P = 0.009) and a reduced length of hospitalization (7.7 ± 4.3 d vs 17.2 ± 17 d; P < 0.001) but no difference in postoperative complications or overall cost. CONCLUSION: LH is safe and cost-effective in overweight and obese patients. Furthermore, LH is significantly associated with fewer postoperative complications and reduced hospital stay compared to OH in these patients. Baishideng Publishing Group Inc 2021-01-27 2021-01-27 /pmc/articles/PMC7830078/ /pubmed/33552392 http://dx.doi.org/10.4240/wjgs.v13.i1.19 Text en ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/ |
spellingShingle | Retrospective Cohort Study Heise, Daniel Bednarsch, Jan Kroh, Andreas Schipper, Sandra Eickhoff, Roman Coolsen, Marielle Van Dam, Ronald Lang, Sven Neumann, Ulf Ulmer, Florian Laparoscopic hepatectomy reduces postoperative complications and hospital stay in overweight and obese patients |
title | Laparoscopic hepatectomy reduces postoperative complications and hospital stay in overweight and obese patients |
title_full | Laparoscopic hepatectomy reduces postoperative complications and hospital stay in overweight and obese patients |
title_fullStr | Laparoscopic hepatectomy reduces postoperative complications and hospital stay in overweight and obese patients |
title_full_unstemmed | Laparoscopic hepatectomy reduces postoperative complications and hospital stay in overweight and obese patients |
title_short | Laparoscopic hepatectomy reduces postoperative complications and hospital stay in overweight and obese patients |
title_sort | laparoscopic hepatectomy reduces postoperative complications and hospital stay in overweight and obese patients |
topic | Retrospective Cohort Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7830078/ https://www.ncbi.nlm.nih.gov/pubmed/33552392 http://dx.doi.org/10.4240/wjgs.v13.i1.19 |
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