Scientific publications
Impact of body mass index on the difficulty and outcomes of laparoscopic left lateral sectionectomy
Zewei Chen 1 , Mengqiu Yin 1 , Junhao Fu 1 , Shian Yu 2 , Nicholas L Syn 3 , Darren W Chua 4 , T Peter Kingham 5 , Wanguang Zhang 6 , Tijs J Hoogteijling 7 , Davit L Aghayan 8 , Tiing Foong Siow 9 , Olivier Scatton 10 , Paulo Herman 11 , Marco V Marino 12 , Vincenzo Mazzaferro 13 , Adrian K H Chiow 14 , Iswanto Sucandy 15 , Arpad Ivanecz 16 , Sung Hoon Choi 17 , Jae Hoon Lee 18 , Mikel Prieto 19 , Marco Vivarelli 20 , Felice Giuliante 21 , Andrea Ruzzenente 22 , Chee-Chien Yong 23 , Safi Dokmak 24 , Constantino Fondevila 25 , Mikhail Efanov 26 , Zenichi Morise 27 , Fabrizio Di Benedetto 28 , Raffaele Brustia 29 , Raffaele Dalla Valle 30 , Ugo Boggi 31 , David Geller 32 , Andrea Belli 33 , Riccardo Memeo 34 , Salvatore Gruttadauria 35 , Alejandro Mejia 36 , James O Park 37 , Fernando Rotellar 38 , Gi-Hong Choi 39 , Ricardo Robles-Campos 40 , Xiaoying Wang 41 , Robert P Sutcliffe 42 , Johann Pratschke 43 , Eric C H Lai 44 , Charing C N Chong 45 , Mathieu D'Hondt 46 , Kazuteru Monden 47 , Santiago Lopez-Ben 48 , Qu Liu 49 , Rong Liu 49 , Alessandro Ferrero 50 , Giuseppe Maria Ettorre 51 , Federica Cipriani 52 , Daniel Cherqui 53 , Xiao Liang 54 , Olivier Soubrane 55 , Go Wakabayashi 56 , Roberto I Troisi 57 , Tan-To Cheung 58 , Yutaro Kato 59 , Atsushi Sugioka 59 , Ho-Seong Han 60 , Tran Cong Duy Long 61 , David Fuks 55 , Mohammad Abu Hilal 62 , Luca Aldrighetti 52 , Kuo-Hsin Chen 9 , Bjørn Edwin 8 , Brian K P Goh 63 ; International robotic and laparoscopic liver resection study group investigators are coauthors of this study
Introduction: Currently, the impact of body mass index (BMI) on the outcomes of laparoscopic liver resections (LLR) is poorly defined. This study attempts to evaluate the impact of BMI on the peri-operative outcomes following laparoscopic left lateral sectionectomy (L-LLS).
Methods: A retrospective analysis of 2183 patients who underwent pure L-LLS at 59 international centers between 2004 and 2021 was performed. Associations between BMI and selected peri-operative outcomes were analyzed using restricted cubic splines.
Results: A BMI of >27kg/m2 was associated with increased in blood loss (Mean difference (MD) 21 mls, 95% CI 5-36), open conversions (Relative risk (RR) 1.13, 95% CI 1.03-1.25), operative time (MD 11 min, 95% CI 6-16), use of Pringles maneuver (RR 1.15, 95% CI 1.06-1.26) and reductions in length of stay (MD -0.2 days, 95% CI -0.3 to -0.1). The magnitude of these differences increased with each unit increase in BMI. However, there was a "U" shaped association between BMI and morbidity with the highest complication rates observed in underweight and obese patients.
Conclusion: Increasing BMI resulted in increasing difficulty of L-LLS. Consideration should be given to its incorporation in future difficulty scoring systems in laparoscopic liver resections.
CITATION Eur J Surg Oncol. 2023 May 3;S0748-7983(23)00435-3. doi: 10.1016/j.ejso.2023.03.235
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