Visceral obesity is a strong predictor of perioperative outcome in patients undergoing laparoscopic radical nephrectomy

Masayuki Hagiwara, Akira Miyajima, Masanori Hasegawa, Masahiro Jinzaki, Eiji Kikuchi, Ken Nakagawa, Mototsugu Oya

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE • To examine the impact of visceral fat on surgical complexity in patients undergoing laparoscopic nephrectomy. PATIENTS AND METHODS • We reviewed the medical records of 121 patients who underwent laparoscopic nephrectomy from 2006 to 2010 at our institution. • The total fat area, visceral fat area (VFA) and subcutaneous fat area were measured at the level of the umbilicus using computed tomography (CT). • To identify the type of obesity, we divided VFA into ≥ 100 cm 2 and < 100 cm 2 . A VFA ≥ 100 cm 2 was used as the definition of visceral obesity. • We evaluated the impact of the VFA on technical difficulties encountered during laparoscopic nephrectomy by measuring operating time. RESULTS • A significant correlation was observed between body mass index (BMI) and operating time ( P < 0.001, r =0.316) in the patients undergoing laparoscopic nephrectomy. • VFA was also significantly correlated with operating time ( P < 0.001, r =0.348), and the correlation coefficient of VFA was higher than that of BMI. • Multivariate analysis showed that a high VFA was an independent risk factor for prolonged operating time ( P =0.009, odds ratio; 3.70), whereas BMI was not found to be a risk factor. CONCLUSIONS • The present data indicate that measurement of VFA by CT is of benefit for predicting the technical difficulty associated with laparoscopic radical nephrectomy. • Visceral obesity, which is one factor involved in metabolic syndrome, has a greater impact than BMI on the complexity of laparoscopic radical nephrectomy.

Original languageEnglish
JournalBJU International
Volume110
Issue number11 C
DOIs
Publication statusPublished - 2012 Dec

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Intra-Abdominal Fat
Abdominal Obesity
Nephrectomy
Body Mass Index
Tomography
Umbilicus
Subcutaneous Fat
Medical Records
Multivariate Analysis
Obesity
Fats
Odds Ratio

Keywords

  • BMI
  • Laparoscopy
  • Metabolic syndrome
  • Nephrectomy
  • Renal cell carcinoma
  • Visceral fat area
  • Visceral obesity

ASJC Scopus subject areas

  • Urology

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Visceral obesity is a strong predictor of perioperative outcome in patients undergoing laparoscopic radical nephrectomy. / Hagiwara, Masayuki; Miyajima, Akira; Hasegawa, Masanori; Jinzaki, Masahiro; Kikuchi, Eiji; Nakagawa, Ken; Oya, Mototsugu.

In: BJU International, Vol. 110, No. 11 C, 12.2012.

Research output: Contribution to journalArticle

Hagiwara, Masayuki ; Miyajima, Akira ; Hasegawa, Masanori ; Jinzaki, Masahiro ; Kikuchi, Eiji ; Nakagawa, Ken ; Oya, Mototsugu. / Visceral obesity is a strong predictor of perioperative outcome in patients undergoing laparoscopic radical nephrectomy. In: BJU International. 2012 ; Vol. 110, No. 11 C.
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N2 - OBJECTIVE • To examine the impact of visceral fat on surgical complexity in patients undergoing laparoscopic nephrectomy. PATIENTS AND METHODS • We reviewed the medical records of 121 patients who underwent laparoscopic nephrectomy from 2006 to 2010 at our institution. • The total fat area, visceral fat area (VFA) and subcutaneous fat area were measured at the level of the umbilicus using computed tomography (CT). • To identify the type of obesity, we divided VFA into ≥ 100 cm 2 and < 100 cm 2 . A VFA ≥ 100 cm 2 was used as the definition of visceral obesity. • We evaluated the impact of the VFA on technical difficulties encountered during laparoscopic nephrectomy by measuring operating time. RESULTS • A significant correlation was observed between body mass index (BMI) and operating time ( P < 0.001, r =0.316) in the patients undergoing laparoscopic nephrectomy. • VFA was also significantly correlated with operating time ( P < 0.001, r =0.348), and the correlation coefficient of VFA was higher than that of BMI. • Multivariate analysis showed that a high VFA was an independent risk factor for prolonged operating time ( P =0.009, odds ratio; 3.70), whereas BMI was not found to be a risk factor. CONCLUSIONS • The present data indicate that measurement of VFA by CT is of benefit for predicting the technical difficulty associated with laparoscopic radical nephrectomy. • Visceral obesity, which is one factor involved in metabolic syndrome, has a greater impact than BMI on the complexity of laparoscopic radical nephrectomy.

AB - OBJECTIVE • To examine the impact of visceral fat on surgical complexity in patients undergoing laparoscopic nephrectomy. PATIENTS AND METHODS • We reviewed the medical records of 121 patients who underwent laparoscopic nephrectomy from 2006 to 2010 at our institution. • The total fat area, visceral fat area (VFA) and subcutaneous fat area were measured at the level of the umbilicus using computed tomography (CT). • To identify the type of obesity, we divided VFA into ≥ 100 cm 2 and < 100 cm 2 . A VFA ≥ 100 cm 2 was used as the definition of visceral obesity. • We evaluated the impact of the VFA on technical difficulties encountered during laparoscopic nephrectomy by measuring operating time. RESULTS • A significant correlation was observed between body mass index (BMI) and operating time ( P < 0.001, r =0.316) in the patients undergoing laparoscopic nephrectomy. • VFA was also significantly correlated with operating time ( P < 0.001, r =0.348), and the correlation coefficient of VFA was higher than that of BMI. • Multivariate analysis showed that a high VFA was an independent risk factor for prolonged operating time ( P =0.009, odds ratio; 3.70), whereas BMI was not found to be a risk factor. CONCLUSIONS • The present data indicate that measurement of VFA by CT is of benefit for predicting the technical difficulty associated with laparoscopic radical nephrectomy. • Visceral obesity, which is one factor involved in metabolic syndrome, has a greater impact than BMI on the complexity of laparoscopic radical nephrectomy.

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