Partial Nephrectomy in the Overweight Patient: an Overview
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  • 作者：Ben Schurhamer ; Nathan Littlejohn ; Ehab Eltahawy ; Rodney Davis…
  • 关键词：Partial nephrectomy ; Overweight ; Obese ; Robotic partial nephrectomy ; Surgical approach ; Overview
  • 刊名：Current Urology Reports
  • 出版年：2016
  • 出版时间：January 2016
  • 年：2016
  • 卷：17
  • 期：1
  • 全文大小：225 KB
  • 参考文献：1.Scosyrev E, Messing EM, Van Poppel H, et al. Renal function after nephron-sparing surgery versus radical nephrectomy: results from EORTC randomized trial 30904. Eur Urol. 2014;65(2):372.PubMed CrossRef
    2.Flegal KM, Carroll MD, Curtin LR, et al. Prevalence and trends in obesity among US adults, 1999–2008. JAMA. 2010;303:235.PubMed CrossRef
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Isac WE, Autorino R, Kaouk JH, et al. The impact of body mass index on surgical outcomes of robotic partial nephrectomy. BJU International. 2012;110(11 Pt C):E997. Retrospective chart review of 250 patients, 71.6% of whom were overweight or obese. They found patients with morbid obesity experienced more blood loss, but did not have an increased transfusion rate, warm ischemia time or postoperative complications.PubMed CrossRef
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Aboumarzouk OM, Stein RJ, Somani BK, et al. Laparoscopic partial nephrectomy in obese patients: a systematic review and meta-analysis. BJU Int. 2012;110(9):1244. Four observational cohort studies comparing 256 obese vs 403 non-obese patients that received a laparoscopic partial nephrectomy. They found no difference in operative duration, warm ischemia time, EBL or hospital stay. There was a slight increase in more serious complications in the obese population.PubMed CrossRef
15.Eaton SH, Thirumavalaven N, Wang DS, et al. Effect of body mass index on perioperative outcomes for laparoscopic partial nephrectomy. J Endourol. 2011;25(9):1447.PubMed CrossRef
16.Reynolds C, Hannon M, Raman JD, et al. An obese body habitus does not preclude a minimally invasive partial nephrectomy. Can J Urol. 2014;21(1):7145.PubMed
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Zargar H, Allaf ME, Bhayani S, et al. Trifecta and optimal perioperative outcomes of robotic and laparoscopic partial nephrectomy in surgical treatment of small renal masses: a multi-institutional study. BJU Int. 2015;116(3):407. This study followed 2932 consecutive cases of RPN and LPN from 5 separate high volume centers. Despite having higher R.E.N.A.L. nephrectomy scores, The RPN group had lower warm ischaemia time (18 vs 26 min), overall complication rate (16.2% vs 25.9%), and positive surgical margin rate (3.2% vs. 9.7%), demonstrating the RPN was superior to LPN as measured by Trifecta.PubMed CrossRef
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Komninos C, Tuliao P, Rha KH, et al. Obesity is not associated with increased operative complications in single-site robotic partial nephrectomy. Yonsei Med J. 2015;56(2):382. This study followed 83 men, divided into obese and normal range. They found no difference in Trifecta, warm ischemia time, EBL, operative time and renal function at 1 year between the 2 groups.PubMed PubMedCentral CrossRef
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  • 作者单位：Ben Schurhamer (1)
    Nathan Littlejohn (1)
    Ehab Eltahawy (1)
    Rodney Davis (1)
    Mohamed Kamel (1)

    1. University of Arkansas for Medical Sciences, 4301 W Markham St, #540, Little Rock, AR, 72205, USA
  • 刊物主题：Urology/Andrology; Nephrology;
  • 出版者：Springer US
  • ISSN：1534-6285
    • 文摘
    The diagnosis and treatment of kidney cancer continues to evolve with advances in imaging and surgical approaches. The use of nephron sparing surgery (NSS) has become the operation of choice for treating small renal masses. Yet, technical difficulty and a variety of approaches have left debate for best method in the overweight population. This review summarizes the current knowledge in the open, laparoscopic, and robotic approaches to identify key risk factors, general assessments, complication rates, and the influence of body habitus for each approach. Keywords Partial nephrectomy Overweight Obese Robotic partial nephrectomy Surgical approach Overview

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