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Impact of body mass index on perioperative outcomes during the learning curve for robot-assisted radical prostatectomy

机译:体重指数对机器人辅助根治性前列腺切除术学习曲线期间围手术期结局的影响

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Introduction: Previous studies of robotic-assisted radical prostatectomy (RARP) have suggested that obesity is a risk factor for worse perioperative outcomes. We evaluated whether body mass index (BMI) adversely affected perioperative outcomes. Methods: A prospective database of 153 RARP (single surgeon) was analyzed. Obesity was defined as BMI ≥ 30 kg/m2; normal BMI 2; and overweight as 25 to 30 kg/m2. Two separate analyses were performed: the first 50 cases (the initial learning curve) and the entire cohort of 153 RARP. Results: In the initial cohort of 50 cases (14 obese patients), there was no statistically significant difference with regards to operative times, port-placement times and estimated blood loss (EBL). Length of stay (LOS) was longer in the obese group (4.3 vs. 2.9 days); BMI remained an independent predictor of increased LOS on multivariate linear regression analysis ( p = 0.002). There was no statistically significant difference in the postoperative outcomes of leak rates, margin rates and incisional herniae. In the entire cohort, when comparing obese patients to those with a normal BMI, there was no statistically significant difference in operative times, EBL, LOS, or immediate postoperative outcomes. However, on multivariate linear regression analysis, BMI was an independent predictor of increased operative time ( p = 0.007). Conclusion: Obese patients do not have an increased risk of blood loss, positive margins or the postoperative complications of incisional hernia and leak during the learning curve. They do, however, have slightly longer operative times; we also noted an increased LOS in our first 50 cases.
机译:简介:先前的机器人辅助前列腺癌根治术(RARP)研究表明,肥胖是围手术期结局恶化的危险因素。我们评估了体重指数(BMI)是否对围手术期结局有不利影响。方法:分析前瞻性数据库中的153位RARP(单一外科医生)。肥胖定义为BMI≥30 kg / m 2 ;正常的BMI 2 ;并且超重为25到30 kg / m 2 。进行了两个单独的分析:前50例(初始学习曲线)和153个RARP的整个队列。结果:在最初的50例患者(14例肥胖患者)中,手术时间,穿刺时间和估计失血量(EBL)在统计学上没有显着差异。肥胖组的住院时间(LOS)更长(4.3天比2.9天);在多元线性回归分析中,BMI仍是LOS升高的独立预测因子(p = 0.002)。漏出率,切缘率和切开疝的术后结果无统计学意义的差异。在整个队列中,将肥胖患者与BMI正常的患者进行比较时,手术时间,EBL,LOS或术后即刻结局均无统计学差异。但是,在多元线性回归分析中,BMI是手术时间增加的独立预测因子(p = 0.007)。结论:肥胖患者在学习过程中不会增加失血,切缘阳性或切开疝和漏出术后并发症的风险。但是,它们的手术时间略长一些。我们还注意到在我们的前50个案例中,LOS有所增加。

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