Visceral fat is correlated with prolonged operative time in laparoendoscopic single-site adrenalectomy and laparoscopic adrenalectomy

Masanori Hasegawa, Akira Miyajima, Masahiro Jinzaki, Takahiro Maeda, Toshikazu Takeda, Eiji Kikuchi, Hirotaka Shibata, Mototsugu Oya

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Abstract

Objective To investigate the effect of visceral fat on operative time and discuss whether the measurement of adipose accumulation could be used as a sensitive predictor of technical difficulty in performing laparoendoscopic single-site adrenalectomy (LESS-A) and laparoscopic adrenalectomy (LA). Methods We reviewed the medical records of 106 patients undergoing LA or LESS-A at our institution. Total fat area (TFA) and visceral fat area (VFA) were measured at the level of the L4 vertebra by computed tomography. To categorize the type of obesity, the VFA/TFA ratio was calculated. Multiple logistic regression analyses were performed to identify independent predictors of prolonged operative time. Results The VFA/TFA ratio does not always coincide with body mass index (BMI, r = 0.415), and a higher correlation coefficient was observed between operative time and the VFA/TFA ratio (r = 0.359) than with that of BMI (r = 0.189). Multivariate analysis revealed that pheochromocytoma, tumor size ≥5 cm, and the VFA/TFA ratio ≥0.35, defined as the visceral type of adipose accumulation, were independent predictive factors for prolonged operative time in LA and LESS-A. We were able to stratify patients into short, intermediate, and long operative times using these preoperative variables. Conclusion This study revealed that the visceral type of adipose accumulation increases operative complexity in LA and LESS-A as measured by operative time. The VFA/TFA ratio might be a more sensitive indicator of technical difficulty than that of BMI.

Original languageEnglish
Pages (from-to)1312-1318
Number of pages7
JournalUrology
Volume82
Issue number6
DOIs
Publication statusPublished - 2013 Dec

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Intra-Abdominal Fat
Adrenalectomy
Operative Time
Fats
Pheochromocytoma
Medical Records
Spine
Body Mass Index
Multivariate Analysis
Obesity
Logistic Models
Tomography
Regression Analysis
Neoplasms

ASJC Scopus subject areas

  • Urology

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Visceral fat is correlated with prolonged operative time in laparoendoscopic single-site adrenalectomy and laparoscopic adrenalectomy. / Hasegawa, Masanori; Miyajima, Akira; Jinzaki, Masahiro; Maeda, Takahiro; Takeda, Toshikazu; Kikuchi, Eiji; Shibata, Hirotaka; Oya, Mototsugu.

In: Urology, Vol. 82, No. 6, 12.2013, p. 1312-1318.

Research output: Contribution to journalArticle

Hasegawa, Masanori ; Miyajima, Akira ; Jinzaki, Masahiro ; Maeda, Takahiro ; Takeda, Toshikazu ; Kikuchi, Eiji ; Shibata, Hirotaka ; Oya, Mototsugu. / Visceral fat is correlated with prolonged operative time in laparoendoscopic single-site adrenalectomy and laparoscopic adrenalectomy. In: Urology. 2013 ; Vol. 82, No. 6. pp. 1312-1318.
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