Impact of body mass index on the difficulty and outcomes of laparoscopic left lateral sectionectomy |
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Affiliation: | 1. Division of Hepatobiliary and General Surgery, Department of Surgery, Humanitas University and Research Hospital, Rozzano, Milan, Italy;2. Humanitas University and Research Hospital, Rozzano, Milan, Italy;3. Department of Pathology, Humanitas University and Research Hospital, Rozzano, Milan, Italy |
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Abstract: | IntroductionCurrently, 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).MethodsA 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.ResultsA 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.ConclusionIncreasing BMI resulted in increasing difficulty of L-LLS. Consideration should be given to its incorporation in future difficulty scoring systems in laparoscopic liver resections. |
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Keywords: | Laparoscopic liver Laparoscopic hepatectomy Minimally-invasive liver Minimally-invasive hepatectomy Body mass index Left lateral sectionectomy |
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