Robot-Assisted Partial Nephrectomy in Obese Patients

Abstract

Purpose:

To report our experience with robot-assisted partial nephrectomy (RAPN) in obese patients compared with a contemporary cohort of nonobese patients.

Patients and Methods:

We defined obesity as a body mass index (BMI) ≥30 kg/m². From June 2004 to September 2009, 97 patients underwent RAPN at our institution, of whom 49 were obese (group 1) and 48 were nonobese (group 2, BMI <30 kg/m²). We compared demographics, operative data, complications, and pathological outcomes between these two groups.

Results:

The average BMI for the obese group was 36.2 kg/m² (range 30.3–49) compared with 25.7 kg/m² (range 20.5–29.7) for the nonobese group. Median tumor size was 2.5 versus 2.3 cm for obese and nonobese groups, respectively. Obese patients had a larger median estimated blood loss (150 vs.100 mL, p = 0.027) and a trend toward a longer median operative time (265 vs. 242.5 minutes, p = 0.085) and median warm ischemia time (26.5 vs. 22.5 minutes, p = 0.074), but this did not achieve statistical significance. An intraoperative complication occurred in one patient in each group. The postoperative complication rate was not statistically significant between the two groups (8.3% vs. 4.3%, p = 0.377). The median hospital stay was 2 days for both groups.

Conclusions:

RAPN is safe and feasible in obese patients. Obese patients had a higher estimated blood loss and a trend toward greater operative time and warm ischemia time, which did not achieve statistical significance.