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Impact of body mass index on the difficulty and outcomes of laparoscopic left lateral sectionectomy

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单位: [1]Department of Hepatobiliary Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China. [2]Department of Hepatobiliary Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China. Electronic address: zjjhysa@163.com. [3]Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore. [4]Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore. [5]Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA. [6]Hepatic Surgery Center and Hubei Key Laboratory of Hepato-Biliary-Pancreatic Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. [7]Department of Surgery, Fondazione Poliambulanza, Brescia, Italy. [8]The Intervention Centre and Department of HPB Surgery, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway. [9]Division of General Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan. [10]Department of Digestive, HBP and Liver Transplantation, Hopital Pitie-Salpetriere, Sorbonne Universite, Paris, France. [11]Liver Surgery Unit, Department of Gastroenterology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil. [12]General Surgery Department, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy; Oncologic Surgery Department, P. Giaccone University Hospital, Palermo, Italy. [13]HPB Surgery and Liver Transplantation, Fondazione IRCCS Istituto Nazionale Tumori di Milano and University of Milan, Milan, Italy. [14]Hepatopancreatobiliary Unit, Department of Surgery, Changi General Hospital, Singapore. [15]Digestive Health Institute, AdventHealth Tampa, Tampa, FL, USA. [16]Department of Abdominal and General Surgery, University Medical Center Maribor, Maribor, Slovenia. [17]Department of General Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea. [18]Department of Surgery, Division of Hepato-Biliary and Pancreatic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. [19]Hepatobiliary Surgery and Liver Transplantation Unit, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country, Bilbao, Spain. [20]HPB Surgery and Transplantation Unit, United Hospital of Ancona, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy. [21]Hepatobiliary Surgery Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University of the Sacred Heart, Rome, Italy. [22]General and Hepatobiliary Surgery, Department of Surgery, Dentistry, Gynecology and Pediatrics University of Verona, GB Rossi Hospital, Verona, Italy. [23]Department of Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan. [24]Department of HPB Surgery and Liver Transplantation, AP-HP, Beaujon Hospital, University of Paris Cite, Clichy, France. [25]General and Digestive Surgery, Hospital Clinic, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain; General and Digestive Surgery, Hospital Universitario La Paz, IdiPAZ, CIBERehd, Madrid, Spain. [26]Department of Hepato-Pancreato-Biliary Surgery, Moscow Clinical Scientific Center, Moscow, Russia. [27]Department of Surgery, Okazaki Medical Center, Fujita Health University School of Medicine, Okazaki, Japan. [28]HPB Surgery and Liver Transplant Unit, University of Modena and Reggio Emilia, Modena, Italy. [29]Department of Digestive and Hepatobiliary and Pancreatic Surgery, AP-HP, Henri-Mondor Hospital, Creteil, France. [30]Hepatobiliary Surgery Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy. [31]Division of General and Transplant Surgery, University of Pisa, Pisa, Italy. [32]Department of Surgery, Division of Hepatobiliary and Pancreatic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. [33]Department of Abdominal Oncology, Division of Hepatopancreatobiliary Surgical Oncology, National Cancer Center - IRCCS-G. Pascale, Naples, Italy. [34]Unit of Hepato-Pancreatc-Biliary Surgery, "F. Miulli" General Regional Hospital, Acquaviva delle Fonti, Bari, Italy. [35]Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (IRCCS-ISMETT), University of Pittsburgh Medical Center Italy, Palermo, Italy; Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy. [36]The Liver Institute, Methodist Dallas Medical Center, Dallas, TX, USA. [37]Department of Surgery, University of Washington Medical Center. Seattle, USA. [38]HPB and Liver Transplant Unit, Department of General Surgery, Clinica Universidad de Navarra, Universidad de Navarra, Pamplona, Spain; Institute of Health Research of Navarra (IdisNA), Pamplona, Spain. [39]Division of Hepatopancreatobiliary Surgery, Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea. [40]Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de la Arrixaca, IMIB-ARRIXACA, El Palmar, Murcia, Spain. [41]Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China. [42]Department of Hepatopancreatobiliary and Liver Transplant Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom. [43]Department of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Berlin, Germany. [44]Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China. [45]Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China. [46]Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, Kortrijk, Belgium. [47]Department of Surgery, Fukuyama City Hospital, Hiroshima, Japan. [48]Hepatobiliary and Pancreatic Surgery Unit, Department of Surgery, Dr. Josep Trueta Hospital, IdIBGi, Girona, Spain. [49]Faculty of Hepatopancreatobiliary Surgery, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China. [50]Department of General and Oncological Surgery, Mauriziano Hospital, Turin, Italy. [51]Division of General Surgery and Liver Transplantation, San Camillo Forlanini Hospital, Rome, Italy. [52]Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy. [53]Department of Hepatobiliary Surgery, Assistance Publique Hopitaux de Paris, Centre Hepato-Biliaire, Paul-Brousse Hospital, Villejuif, France. [54]Department of General Surgery, Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China. [55]Department of Digestive, Oncologic and Metabolic Surgery, Institute Mutualiste Montsouris, Universite Paris Descartes, Paris, France. [56]Center for Advanced Treatment of Hepatobiliary and Pancreatic Diseases, Ageo Central General Hospital, Saitama, Japan. [57]Department of Clinical Medicine and Surgery, Division of HPB, Minimally Invasive and Robotic Surgery, Federico II University Hospital Naples, Naples, Italy. [58]Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China. [59]Department of Surgery, Fujita Health University School of Medicine, Aichi, Japan. [60]Department of Surgery, Seoul National University Hospital Bundang, Seoul National University College of Medicine, Seoul, South Korea. [61]Department of Hepatopancreatobiliary Surgery, University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh City, Viet Nam. [62]Department of Surgery, Fondazione Poliambulanza, Brescia, Italy; Department of Surgery, University Hospital Southampton, United Kingdom. [63]Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore; Surgery Academic Clinical Programme, Duke-National University of Singapore Medical School, Singapore. Electronic address: bsgkp@hotmail.com.
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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).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.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.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.Copyright © 2023 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

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出版当年[2022]版:
大类 | 2 区 医学
小类 | 2 区 外科 3 区 肿瘤学
最新[2025]版:
大类 | 2 区 医学
小类 | 2 区 肿瘤学 2 区 外科
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出版当年[2021]版:
Q1 SURGERY Q3 ONCOLOGY
最新[2023]版:
Q1 SURGERY Q2 ONCOLOGY

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第一作者单位: [1]Department of Hepatobiliary Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China.
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