The University of Southampton
University of Southampton Institutional Repository

Laparoscopic partial nephrectomy in obese patients: a systematic review and meta-analysis

Laparoscopic partial nephrectomy in obese patients: a systematic review and meta-analysis
Laparoscopic partial nephrectomy in obese patients: a systematic review and meta-analysis

What's known on the subject? And What does the study add? The literature yielded only four studies on the subject; however, no clear outcome can be taken from individual studies. This review adds a meta-analysis of these four studies to make the patient cohort larger and to allow for a greater understanding of the procedure in this select group of patients. • To compare the safety and efficacy of laparoscopic partial nephrectomy (LPN) in obese and non-obese patients. • We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1966 to November 2011), EMBASE (1980 to November 2011), CINAHL, Clinicaltrials.gov, Google Scholar, reference lists of articles and abstracts from conference proceedings without language restriction for studies comparing LPN in obese and non-obese patients. • Four observational cohort studies were included for 256 obese patients compared with 403 non-obese patients who underwent LPN. • There was no difference in operative duration (mean difference [MD] 5.64, 95% confidence interval [CI]-3.80 to 15.09), warm ischaemic time (MD -1.04, 95% CI -2.68 to 0.59), estimated blood loss (MD 53.73, 95% CI 0.72-106.74) or hospital stay (MD -0.04, 95% CI -0.30 to 0.22). • There was no difference in complications in total (odds ratio [OR] 1.02, 95% CI 0.70-1.49), intraoperative complications (OR 0.68, 95% CI 0.30-1.53), or postoperative complications (OR 1.15, 95% CI 0.75-1.77). • The obese group had significantly more Clavien grade III complications (OR 3.95, 95% CI 1.36-11.42), despite the low absolute incidence, with 4.3% (11/256) in the obese group vs 1.5% (6/403) in the non-obese group. • Experienced laparoscopic surgeons can safely and efficiently perform PN for obese patients with comparable results to those of non-obese patients. • The likelihood of major (Clavien Classification ≥ III) complications is higher for the obese patient.

Carcinoma, Renal Cell, Humans, Kidney Neoplasms, Laparoscopy, Middle Aged, Nephrectomy, Obesity, Operative Time, Comparative Study, Evaluation Studies, Journal Article, Meta-Analysis, Review
1464-4096
1244-1250
Aboumarzouk, Omar M
3c7e2433-638d-4378-9931-902fdc68acce
Stein, Robert J
4590c88a-5a22-445f-8e7e-65204279cb11
Haber, Georges-Pascal
4e792ea4-1941-4efb-a212-8915d5b3c618
Kaouk, Jihad
bc0e922a-b91e-4cf1-94a2-53f941aeae5b
Chlosta, Piotr L
f15638f2-4870-42e8-a972-a179a7573cb5
Somani, Bhaskar K
ab5fd1ce-02df-4b88-b25e-8ece396335d9
Aboumarzouk, Omar M
3c7e2433-638d-4378-9931-902fdc68acce
Stein, Robert J
4590c88a-5a22-445f-8e7e-65204279cb11
Haber, Georges-Pascal
4e792ea4-1941-4efb-a212-8915d5b3c618
Kaouk, Jihad
bc0e922a-b91e-4cf1-94a2-53f941aeae5b
Chlosta, Piotr L
f15638f2-4870-42e8-a972-a179a7573cb5
Somani, Bhaskar K
ab5fd1ce-02df-4b88-b25e-8ece396335d9

Aboumarzouk, Omar M, Stein, Robert J, Haber, Georges-Pascal, Kaouk, Jihad, Chlosta, Piotr L and Somani, Bhaskar K (2012) Laparoscopic partial nephrectomy in obese patients: a systematic review and meta-analysis. BJU International, 110 (9), 1244-1250. (doi:10.1111/j.1464-410X.2012.11094.x).

Record type: Review

Abstract

What's known on the subject? And What does the study add? The literature yielded only four studies on the subject; however, no clear outcome can be taken from individual studies. This review adds a meta-analysis of these four studies to make the patient cohort larger and to allow for a greater understanding of the procedure in this select group of patients. • To compare the safety and efficacy of laparoscopic partial nephrectomy (LPN) in obese and non-obese patients. • We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1966 to November 2011), EMBASE (1980 to November 2011), CINAHL, Clinicaltrials.gov, Google Scholar, reference lists of articles and abstracts from conference proceedings without language restriction for studies comparing LPN in obese and non-obese patients. • Four observational cohort studies were included for 256 obese patients compared with 403 non-obese patients who underwent LPN. • There was no difference in operative duration (mean difference [MD] 5.64, 95% confidence interval [CI]-3.80 to 15.09), warm ischaemic time (MD -1.04, 95% CI -2.68 to 0.59), estimated blood loss (MD 53.73, 95% CI 0.72-106.74) or hospital stay (MD -0.04, 95% CI -0.30 to 0.22). • There was no difference in complications in total (odds ratio [OR] 1.02, 95% CI 0.70-1.49), intraoperative complications (OR 0.68, 95% CI 0.30-1.53), or postoperative complications (OR 1.15, 95% CI 0.75-1.77). • The obese group had significantly more Clavien grade III complications (OR 3.95, 95% CI 1.36-11.42), despite the low absolute incidence, with 4.3% (11/256) in the obese group vs 1.5% (6/403) in the non-obese group. • Experienced laparoscopic surgeons can safely and efficiently perform PN for obese patients with comparable results to those of non-obese patients. • The likelihood of major (Clavien Classification ≥ III) complications is higher for the obese patient.

Full text not available from this repository.

More information

e-pub ahead of print date: 3 April 2012
Published date: November 2012
Additional Information: © 2012 THE AUTHORS. BJU INTERNATIONAL © 2012 BJU INTERNATIONAL.
Keywords: Carcinoma, Renal Cell, Humans, Kidney Neoplasms, Laparoscopy, Middle Aged, Nephrectomy, Obesity, Operative Time, Comparative Study, Evaluation Studies, Journal Article, Meta-Analysis, Review

Identifiers

Local EPrints ID: 419084
URI: https://eprints.soton.ac.uk/id/eprint/419084
ISSN: 1464-4096
PURE UUID: b806f5be-ef8d-44d8-b2b1-8e3490c7337f

Catalogue record

Date deposited: 29 Mar 2018 16:30
Last modified: 13 Mar 2019 18:44

Export record

Altmetrics

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of https://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×