AI Article Synopsis
- Laparoscopic liver resection (LLR) is becoming more common, but there's limited data on how it affects obese patients, which prompted this study to review existing literature.
- A systematic search of multiple databases identified seven studies analyzing outcomes from 481 obese and 1180 non-obese patients, revealing variations in obesity definitions and some increased risks for obese patients, like higher wound infection rates.
- The findings suggest LLR is safe for obese patients, with no significant differences in mortality or major complications, though more research is needed to confirm these results.
Article Abstract
Background: Laparoscopic liver resection is gaining momentum; however, there is limited evidence on its efficacy and safety in obese patients. The aim of this study was to examine the relationship between BMI and outcomes after laparoscopic liver resection (LLR) using a systematic review of the existing literature.
Methods: A systematic search of Medline (Ovid 1946-present), PubMed (NCBI), Embase (Ovid 1966-present) and Cochrane Library was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement for parameters of LLR and BMI. Operative, post-operative and oncological outcomes were recorded.
Results: Of 1460 abstracts, seven retrospective studies were analysed, published between 2015 and 2017 (study periods 1998-2017). Total patient cohort were classified as 481 obese and 1180 non-obese with a median age range of 42.5-69.4 years. Variations existed in definitions of obesity (Asia BMI >25 kg/m , Western BMI >30 kg/m ). Rates of conversion were examined in four studies (0-31%) with one reporting BMI >28 kg/m as an independent risk factor. Estimated blood loss and transfusion rates were similar. Operative time was increased in obese patients in one study (P = 0.02). Mortality rates ranged from 0% to 4.3% with no difference between BMI classes. No difference in major morbidity was demonstrated. Bile leak rates were increased in obese groups in one study (0-3.44%, P < 0.05). Wound infections were reported in five studies, with higher rates in obese patients (0-5.8% versus 0-1.9%). Tumour size was comparable in both groups. Completeness of resection was analysed in four studies with one study reporting increased R0 rates in obese patients (P = 0.012).
Conclusion: This systematic review highlights that current evidence shows LLR in obese patients is safe, however, further studies are required.
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| http://dx.doi.org/10.1111/ans.16674 | DOI Listing |
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