Abstract：Objective:To study the effect of body mass index (BMI) on the perioperative safety of retroperitoneal approach robot assisted partial nephrectomy (RPRPN). Methods:Clinical data of 267 patients receiving RPRPN in Chines PLA General Hospital from January 2015 to December 2016 were retrospectively analyzed, including the operation time, warm ischemia time, intraoperative estimated blood loss, positive margin, postoperative hospital stay, perioperative complications. The correlation of BMI and perioperative factors was analyzed. Results:There were 175 males and 92 females, aged 18 to 85 years old, with an average age of (51.38±12.4) years. 267 cases were divided into 3 groups according to the Chinese population BMI standard of Working Group on Obesity in China (WGOC), including BMI <24 kg/m2 (normal), 24.0-27.9 kg/m2 (overweight), 28 kg/m2 (obesity). The age, gender, CCI score, tumor diameter and R.E.N.A.L score among the groups showed no statistically significant difference. RPRPN was performed successfully on all the 267 cases without conversion to open surgery. There were also no statistically significant differences in the operation time, warm ischemia time, intraoperative estimated blood loss, positive margin, postoperative hospital stay and perioperative complications among three groups. Conclusions:The RPRPN is effective and safe in overweight and obese patients.
吕香君, 唐露, 张旭, 马鑫, 李宏召, 李新涛. 体质指数对后腹腔入路机器人肾部分切除术围手术期安全性的影响[J]. 微创泌尿外科杂志, 2018, 7(2): 73-76.
Lyu Xiangjun, Tang Lu, Zhang Xu, Ma Xin, Li Hongzhao, Li Xintao. Effect of body mass index on the perioperative safety of retroperitoneal approach robot assisted partial nephrectomy. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2018, 7(2): 73-76.
[1] Campbell SC, Novick AC, Belldegrun A, et al.Guideline for management of the clinical T1 renal mass. J Urol, 2009,182(4):1271-1279. [2] Scosyrev E, Messing EM, Sylvester R, et al.Renal function after nephron-sparing surgery versus radical nephrectomy: results from EORTC randomized trial 30904. Eur Urol, 2014,65(2):372-377. [3] Rogers C, Sukumar S, Gill IS.Robotic partial nephrectomy:the renal benefit. Curr Opin Urol, 2011,21(1):60-64. [4] 汤昊,张征宇,周文泉,等.经腹与腹膜后入路机器人辅助腹腔镜肾部分切除术治疗早期肾癌的比较.临床肿瘤学杂志,2015,20(12):1128-1131. [5] 王共先,傅斌,刘伟鹏,等.经腹膜后入路机器人手术治疗肾肿瘤的技术与经验的探讨(附45例报告).临床泌尿外科杂志,2016,31(1):19-22,28. [6] 李新涛,张旭,吕香君.后腹腔入路机器人肾部分切除术:手术效果与技术现状.微创泌尿外科杂志,2016,5(2):124-128. [7] 袁建林,孟平,杨晓剑,等.经腹腔和后腹腔入路机器人辅助腹腔镜下肾部分切除术治疗肾门肿瘤的临床研究.中华泌尿外科杂志,2017,28(7):502-506. [8] Zhou BF.Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults - study on optimal cut-off points of body mass index and waist circumference in Chinese adults. Biomed Environ Sci, 2002,11(1):83-96. [9] 吕香君,张旭,马鑫,等.经后腹腔入路机器人肾部分切除术手术经验和临床疗效总结(附单中心189例病例报道).微创泌尿外科杂志,2016,5(02):65-68. [10] 吕香君,张旭,马鑫,等.经后腹腔与经腹腔入路机器人肾部分切除术的对照研究:单中心418例报告.中华泌尿外科杂志,2016,37(9):641-646. [11] Hennessey DB, Bolton EM, Thomas AZ, et al.The effect of obesity and increased waist circumference on the outcome of laparoscopic nephrectomy. Adv Urol, 2017,2017:3941727. [12] Arfi N, Baldini A, Decaussin-Petrucci M, et al.Impact of obesity on complications of laparoscopic simple or radical nephrectomy. Curr Urol, 2015,8(3):149-155. [13] Komninos C, Tuliao P, Koo KC, et al.Obesity is not associated with increased operative complications in single-site robotic partial nephrectomy. Yonsei Med J, 2015,56(2):382-287. [14] Ioffe E, Hakimi AA, Oh SK, et al.Effect of visceral obesity on minimally invasive partial nephrectomy. Urology, 2013,82(3):612-618. [15] 崔茜,管春丽,王涛.机器人辅助后腹腔镜肾部分切除术的手术配合.中华腔镜外科杂志(电子版),2016,9(5):314-316. [16] 唐露,李新涛,吕香君,等.机器人手术助手对后腹腔入路机器人肾部分切除术围手术期的影响.微创泌尿外科杂志,2017,6(1):32-35.
