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Background: Data on the effect of body mass index on laparoscopic liver resections are conflicting. We performed this study to investigate the association between body mass index and postoperative outcomes after laparoscopic major hepatectomies. Methods: This is a retrospective review of 4,348 laparoscopic major hepatectomies at 58 centers between 2005 and 2021, of which 3,383 met the study inclusion criteria. Concomitant major operations, vascular resections, and previous liver resections were excluded. Associations between body mass index and perioperative outcomes were analyzed using restricted cubic splines. Modeled effect sizes were visually rendered and summarized. Results: A total of 1,810 patients (53.5%) had normal weight, whereas 1,057 (31.2%) were overweight and 392 (11.6%) were obese. One hundred and twenty-four patients (3.6%) were underweight. Most perioperative outcomes showed a linear worsening trend with increasing body mass index. There was a statistically significant increase in open conversion rate (16.3%, 10.8%, 9.2%, and 5.6%, P < .001), longer operation time (320 vs 305 vs 300 and 266 minutes, P < .001), increasing blood loss (300 vs 300 vs 295 vs 250 mL, P = .022), and higher postoperative morbidity (33.4% vs 26.3% vs 25.0% vs 25.0%, P = .009) in obese, overweight, normal weight, and underweight patients, respectively (P < .001). However, postoperative major morbidity demonstrated a "U"-shaped association with body mass index, whereby the highest major morbidity rates were observed in underweight and obese patients. Conclusion: Laparoscopic major hepatectomy was associated with poorer outcomes with increasing body mass index for most perioperative outcome measures.
Impact of body mass index on perioperative outcomes of laparoscopic major hepatectomies
Berardi, Giammauro;Kingham, T Peter;Zhang, Wanguang;Syn, Nicholas L;Koh, Ye-Xin;Jaber, Bashar;Aghayan, Davit L;Siow, Tiing Foong;Lim, Chetana;Scatton, Olivier;Herman, Paulo;Coelho, Fabricio Ferreira;Marino, Marco V;Mazzaferro, Vincenzo;Chiow, Adrian K H;Sucandy, Iswanto;Ivanecz, Arpad;Choi, Sung Hoon;Lee, Jae Hoon;Gastaca, Mikel;Vivarelli, Marco;Giuliante, Felice;Dalla Valle, Bernardo;Ruzzenente, Andrea;Yong, Chee-Chien;Chen, Zewei;Yin, Mengqiu;Fondevila, Constantino;Efanov, Mikhail;Morise, Zenichi;Di Benedetto, Fabrizio;Brustia, Raffaele;Dalla Valle, Raffaele;Boggi, Ugo;Geller, David;Belli, Andrea;Memeo, Riccardo;Gruttadauria, Salvatore;Mejia, Alejandro;Park, James O;Rotellar, Fernando;Choi, Gi-Hong;Robles-Campos, Ricardo;Wang, Xiaoying;Sutcliffe, Robert P;Schmelzle, Moritz;Pratschke, Johann;Lai, Eric C H;Chong, Charing C N;Meurs, Juul;D'Hondt, Mathieu;Monden, Kazuteru;Lopez-Ben, Santiago;Liu, Qu;Liu, Rong;Ferrero, Alessandro;Ettorre, Giuseppe Maria;Cipriani, Federica;Pascual, Franco;Cherqui, Daniel;Zheng, Junhao;Liang, Xiao;Soubrane, Olivier;Wakabayashi, Go;Troisi, Roberto I;Cheung, Tan-To;Kato, Yutaro;Sugioka, Atsushi;D'Silva, Mizelle;Han, Ho-Seong;Nghia, Phan Phuoc;Long, Tran Cong Duy;Edwin, Bjørn;Fuks, David;Abu Hilal, Mohammad;Aldrighetti, Luca;Chen, Kuo-Hsin;Goh, Brian K P
2023-01-01
Abstract
Background: Data on the effect of body mass index on laparoscopic liver resections are conflicting. We performed this study to investigate the association between body mass index and postoperative outcomes after laparoscopic major hepatectomies. Methods: This is a retrospective review of 4,348 laparoscopic major hepatectomies at 58 centers between 2005 and 2021, of which 3,383 met the study inclusion criteria. Concomitant major operations, vascular resections, and previous liver resections were excluded. Associations between body mass index and perioperative outcomes were analyzed using restricted cubic splines. Modeled effect sizes were visually rendered and summarized. Results: A total of 1,810 patients (53.5%) had normal weight, whereas 1,057 (31.2%) were overweight and 392 (11.6%) were obese. One hundred and twenty-four patients (3.6%) were underweight. Most perioperative outcomes showed a linear worsening trend with increasing body mass index. There was a statistically significant increase in open conversion rate (16.3%, 10.8%, 9.2%, and 5.6%, P < .001), longer operation time (320 vs 305 vs 300 and 266 minutes, P < .001), increasing blood loss (300 vs 300 vs 295 vs 250 mL, P = .022), and higher postoperative morbidity (33.4% vs 26.3% vs 25.0% vs 25.0%, P = .009) in obese, overweight, normal weight, and underweight patients, respectively (P < .001). However, postoperative major morbidity demonstrated a "U"-shaped association with body mass index, whereby the highest major morbidity rates were observed in underweight and obese patients. Conclusion: Laparoscopic major hepatectomy was associated with poorer outcomes with increasing body mass index for most perioperative outcome measures.
Berardi, Giammauro; Kingham, T Peter; Zhang, Wanguang; Syn, Nicholas L; Koh, Ye-Xin; Jaber, Bashar; Aghayan, Davit L; Siow, Tiing Foong; Lim, Chetana; Scatton, Olivier; Herman, Paulo; Coelho, Fabricio Ferreira; Marino, Marco V; Mazzaferro, Vincenzo; Chiow, Adrian K H; Sucandy, Iswanto; Ivanecz, Arpad; Choi, Sung Hoon; Lee, Jae Hoon; Gastaca, Mikel; Vivarelli, Marco; Giuliante, Felice; Dalla Valle, Bernardo; Ruzzenente, Andrea; Yong, Chee-Chien; Chen, Zewei; Yin, Mengqiu; Fondevila, Constantino; Efanov, Mikhail; Morise, Zenichi; Di Benedetto, Fabrizio; Brustia, Raffaele; Dalla Valle, Raffaele; Boggi, Ugo; Geller, David; Belli, Andrea; Memeo, Riccardo; Gruttadauria, Salvatore; Mejia, Alejandro; Park, James O; Rotellar, Fernando; Choi, Gi-Hong; Robles-Campos, Ricardo; Wang, Xiaoying; Sutcliffe, Robert P; Schmelzle, Moritz; Pratschke, Johann; Lai, Eric C H; Chong, Charing C N; Meurs, Juul; D'Hondt, Mathieu; Monden, Kazuteru; Lopez-Ben, Santiago; Liu, Qu; Liu, Rong; Ferrero, Alessandro; Ettorre, Giuseppe Maria; Cipriani, Federica; Pascual, Franco; Cherqui, Daniel; Zheng, Junhao; Liang, Xiao; Soubrane, Olivier; Wakabayashi, Go; Troisi, Roberto I; Cheung, Tan-To; Kato, Yutaro; Sugioka, Atsushi; D'Silva, Mizelle; Han, Ho-Seong; Nghia, Phan Phuoc; Long, Tran Cong Duy; Edwin, Bjørn; Fuks, David; Abu Hilal, Mohammad; Aldrighetti, Luca; Chen, Kuo-Hsin; Goh, Brian K P
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11568/1190287
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simulazione ASN
Il report seguente simula gli indicatori relativi alla propria produzione scientifica in relazione alle soglie ASN 2023-2025 del proprio SC/SSD. Si ricorda che il superamento dei valori soglia (almeno 2 su 3) è requisito necessario ma non sufficiente al conseguimento dell'abilitazione. La simulazione si basa sui dati IRIS e sugli indicatori bibliometrici alla data indicata e non tiene conto di eventuali periodi di congedo obbligatorio, che in sede di domanda ASN danno diritto a incrementi percentuali dei valori. La simulazione può differire dall'esito di un’eventuale domanda ASN sia per errori di catalogazione e/o dati mancanti in IRIS, sia per la variabilità dei dati bibliometrici nel tempo. Si consideri che Anvur calcola i valori degli indicatori all'ultima data utile per la presentazione delle domande.
La presente simulazione è stata realizzata sulla base delle specifiche raccolte sul tavolo ER del Focus Group IRIS coordinato dall’Università di Modena e Reggio Emilia e delle regole riportate nel DM 589/2018 e allegata Tabella A. Cineca, l’Università di Modena e Reggio Emilia e il Focus Group IRIS non si assumono alcuna responsabilità in merito all’uso che il diretto interessato o terzi faranno della simulazione. Si specifica inoltre che la simulazione contiene calcoli effettuati con dati e algoritmi di pubblico dominio e deve quindi essere considerata come un mero ausilio al calcolo svolgibile manualmente o con strumenti equivalenti.