Retroperitoneoskopik nefrektomi obez hastalarda transperitoneal laparoskopik nefrektomiden daha iyi perioperatif sonuçlara sahiptir

Translated title of the contribution: Retroperitoneoscopic nephrectomy has better perioperative outcomes than transperitoneal laparoscopic nephrectomy in obese patients

Selçuk Erdem, Öner Şanli, Tzevat Tefik, Tayfun Oktar, Mazhar Ortac, Meltem Karadeniz, Faruk Özcan

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: This retrospective, case-controlled study compares the operative outcomes of retroperitoneoscopic nephrectomy (RN) and transperitoneal laparoscopic nephrectomy (TLN) in obese patients. Materials and Methods: A total of 202 operations, including 114 radical and 88 simple nephrectomies were identified from our prospectively collected institutional laparoscopic nephrectomy database. Patients were stratified into 3 groups according to the World Health Organization's body mass index (BMI) classification: normal (Group 1-BMI <25 kg/m 2, n=68), overweight (Group 2-25 kg/m 2 ≤ BMI <30 kg/m 2, n=88) and obese (Group 3-BMI ≥30 kg/m 2, n=46). Furthermore, each group was divided into two subgroups according to the operation performed (RN or TLN). Perioperative parameters were compared statistically between the RN and TLN subgroups in all of the BMI-stratified categories. Results: The results for mean operative time (p<0.001, p=0.034 and p=0.005), estimated blood loss (p<0.001, p<0.001 and p=0.002) and length of hospital stay (p=0.005, p<0.001 and p<0.001) were all significantly in favor of RN in Groups 1, 2 and 3, respectively. The complication rate did not significantly differ between RN and TLN in the BMI-stratified groups. Conversely, the open conversion rate was significantly higher for TLN in Group 1 (p=0.024); this rate was similar for RN and TLN in Group 2 (p=0.22) and Group 3 (p=0.658). Conclusion: Retroperitoneoscopic nephrectomy has better perioperative outcomes in obese patients; these outcomes are similar to those seen in non-obese patients. However, both retroperitoneoscopic and transperitoneal laparoscopic operations can be safely performed, with the same complication and open conversion rates, in obese patients.

Original languageTurkish
Pages (from-to)80-87
Number of pages8
JournalTurk Uroloji Dergisi
Volume38
Issue number2
DOIs
StatePublished - Jun 1 2012

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Nephrectomy
Body Mass Index
Length of Stay
Operative Time

Keywords

  • Nephrectomy
  • Obesity
  • Retroperitoneoscopic
  • Transperitoneal laparoscopic

ASJC Scopus subject areas

  • Urology

Cite this

Retroperitoneoskopik nefrektomi obez hastalarda transperitoneal laparoskopik nefrektomiden daha iyi perioperatif sonuçlara sahiptir. / Erdem, Selçuk; Şanli, Öner; Tefik, Tzevat; Oktar, Tayfun; Ortac, Mazhar; Karadeniz, Meltem; Özcan, Faruk.

In: Turk Uroloji Dergisi, Vol. 38, No. 2, 01.06.2012, p. 80-87.

Research output: Contribution to journalArticle

Erdem, Selçuk ; Şanli, Öner ; Tefik, Tzevat ; Oktar, Tayfun ; Ortac, Mazhar ; Karadeniz, Meltem ; Özcan, Faruk. / Retroperitoneoskopik nefrektomi obez hastalarda transperitoneal laparoskopik nefrektomiden daha iyi perioperatif sonuçlara sahiptir. In: Turk Uroloji Dergisi. 2012 ; Vol. 38, No. 2. pp. 80-87.
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abstract = "Objective: This retrospective, case-controlled study compares the operative outcomes of retroperitoneoscopic nephrectomy (RN) and transperitoneal laparoscopic nephrectomy (TLN) in obese patients. Materials and Methods: A total of 202 operations, including 114 radical and 88 simple nephrectomies were identified from our prospectively collected institutional laparoscopic nephrectomy database. Patients were stratified into 3 groups according to the World Health Organization's body mass index (BMI) classification: normal (Group 1-BMI <25 kg/m 2, n=68), overweight (Group 2-25 kg/m 2 ≤ BMI <30 kg/m 2, n=88) and obese (Group 3-BMI ≥30 kg/m 2, n=46). Furthermore, each group was divided into two subgroups according to the operation performed (RN or TLN). Perioperative parameters were compared statistically between the RN and TLN subgroups in all of the BMI-stratified categories. Results: The results for mean operative time (p<0.001, p=0.034 and p=0.005), estimated blood loss (p<0.001, p<0.001 and p=0.002) and length of hospital stay (p=0.005, p<0.001 and p<0.001) were all significantly in favor of RN in Groups 1, 2 and 3, respectively. The complication rate did not significantly differ between RN and TLN in the BMI-stratified groups. Conversely, the open conversion rate was significantly higher for TLN in Group 1 (p=0.024); this rate was similar for RN and TLN in Group 2 (p=0.22) and Group 3 (p=0.658). Conclusion: Retroperitoneoscopic nephrectomy has better perioperative outcomes in obese patients; these outcomes are similar to those seen in non-obese patients. However, both retroperitoneoscopic and transperitoneal laparoscopic operations can be safely performed, with the same complication and open conversion rates, in obese patients.",
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AU - Erdem, Selçuk

AU - Şanli, Öner

AU - Tefik, Tzevat

AU - Oktar, Tayfun

AU - Ortac, Mazhar

AU - Karadeniz, Meltem

AU - Özcan, Faruk

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N2 - Objective: This retrospective, case-controlled study compares the operative outcomes of retroperitoneoscopic nephrectomy (RN) and transperitoneal laparoscopic nephrectomy (TLN) in obese patients. Materials and Methods: A total of 202 operations, including 114 radical and 88 simple nephrectomies were identified from our prospectively collected institutional laparoscopic nephrectomy database. Patients were stratified into 3 groups according to the World Health Organization's body mass index (BMI) classification: normal (Group 1-BMI <25 kg/m 2, n=68), overweight (Group 2-25 kg/m 2 ≤ BMI <30 kg/m 2, n=88) and obese (Group 3-BMI ≥30 kg/m 2, n=46). Furthermore, each group was divided into two subgroups according to the operation performed (RN or TLN). Perioperative parameters were compared statistically between the RN and TLN subgroups in all of the BMI-stratified categories. Results: The results for mean operative time (p<0.001, p=0.034 and p=0.005), estimated blood loss (p<0.001, p<0.001 and p=0.002) and length of hospital stay (p=0.005, p<0.001 and p<0.001) were all significantly in favor of RN in Groups 1, 2 and 3, respectively. The complication rate did not significantly differ between RN and TLN in the BMI-stratified groups. Conversely, the open conversion rate was significantly higher for TLN in Group 1 (p=0.024); this rate was similar for RN and TLN in Group 2 (p=0.22) and Group 3 (p=0.658). Conclusion: Retroperitoneoscopic nephrectomy has better perioperative outcomes in obese patients; these outcomes are similar to those seen in non-obese patients. However, both retroperitoneoscopic and transperitoneal laparoscopic operations can be safely performed, with the same complication and open conversion rates, in obese patients.

AB - Objective: This retrospective, case-controlled study compares the operative outcomes of retroperitoneoscopic nephrectomy (RN) and transperitoneal laparoscopic nephrectomy (TLN) in obese patients. Materials and Methods: A total of 202 operations, including 114 radical and 88 simple nephrectomies were identified from our prospectively collected institutional laparoscopic nephrectomy database. Patients were stratified into 3 groups according to the World Health Organization's body mass index (BMI) classification: normal (Group 1-BMI <25 kg/m 2, n=68), overweight (Group 2-25 kg/m 2 ≤ BMI <30 kg/m 2, n=88) and obese (Group 3-BMI ≥30 kg/m 2, n=46). Furthermore, each group was divided into two subgroups according to the operation performed (RN or TLN). Perioperative parameters were compared statistically between the RN and TLN subgroups in all of the BMI-stratified categories. Results: The results for mean operative time (p<0.001, p=0.034 and p=0.005), estimated blood loss (p<0.001, p<0.001 and p=0.002) and length of hospital stay (p=0.005, p<0.001 and p<0.001) were all significantly in favor of RN in Groups 1, 2 and 3, respectively. The complication rate did not significantly differ between RN and TLN in the BMI-stratified groups. Conversely, the open conversion rate was significantly higher for TLN in Group 1 (p=0.024); this rate was similar for RN and TLN in Group 2 (p=0.22) and Group 3 (p=0.658). Conclusion: Retroperitoneoscopic nephrectomy has better perioperative outcomes in obese patients; these outcomes are similar to those seen in non-obese patients. However, both retroperitoneoscopic and transperitoneal laparoscopic operations can be safely performed, with the same complication and open conversion rates, in obese patients.

KW - Nephrectomy

KW - Obesity

KW - Retroperitoneoscopic

KW - Transperitoneal laparoscopic

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