BJUI Mini Reviews - Laparoscopic partial nephrectomy in obese patients: A systematic review and meta-analysis

BERKELEY, CA (UroToday.com) - Worldwide, obesity is on the rise and is now considered an epidemic with >300 million people afflicted. About 25-34% of the adult population of the USA are considered obese.

Evidence suggests that the incidence of RCC increases with obesity, but that obese patients might have a better prognosis compared with non-obese patients.bjui 110 9 coverWith advances in imaging technology the detection of smaller RCCs has increased, leading to current figures of up to 60% of RCC being <4 cm. The identification of smaller renal tumours has led to an increase in the number of patients who are candidates for partial nephrectomy (PN) resulting in decreased renal insufficiency.

With advances in laparoscopic techniques, equipment, and operator skill, laparoscopic PN (LPN) has emerged as a viable alternative to open PN with comparable oncological outcomes,less morbidity, and faster recovery. However, there are certain circumstances that may make LPN more challenging, e.g. operating on obese patients. These patients not only tend to have a prolonged procedure but also often have multiple co-morbidities with a higher risk of intra and postoperative complications...View or save the full text Mini Review as a .pdf file

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.


Omar M. Aboumarzouk, Robert J. Stein,* Georges-Pascal Haber,* Jihad Kaouk,* Piotr L. Chlosta, and Bhaskar K. Somani

The Royal Bournemouth and Christchurch Hospitals NHS Trust, Urology Department, Bournemouth, UK, *Cleveland Clinic, Glickman Urologic and Kidney Institute, Cleveland, Ohio, USA , Faculty of Health, Jan Kochanowski University, Holy Cross Cancer Centre, Department of Urology Institute of Oncology, Kielce, Poland , and Southampton University Hospitals NHS Trust, Southampton, UK

 



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