AI Article Synopsis
- - The study investigates how body mass index (BMI) affects outcomes after laparoscopic left lateral sectionectomy (L-LLS), revealing that higher BMI levels (greater than 27kg/m²) lead to increased blood loss, longer operative times, and more open conversions during surgery.
- - A large sample of 2,183 patients from 59 centers worldwide was analyzed, showing that as BMI increases, so do certain negative surgical outcomes, but patient complications also exhibited a "U" shaped relationship—higher rates were seen in both underweight and obese individuals.
- - The findings suggest that BMI should be considered in evaluating the difficulty of L-LLS procedures and in future assessments of surgical risk and outcomes.
Article Abstract
Introduction: Currently, 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).
Methods: A 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.
Results: A 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.
Conclusion: Increasing 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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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10979757 | PMC |
| http://dx.doi.org/10.1016/j.ejso.2023.03.235 | DOI Listing |
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