TY - JOUR
T1 - Visceral obesity is a strong predictor of perioperative outcome in patients undergoing laparoscopic radical nephrectomy
AU - Hagiwara, Masayuki
AU - Miyajima, Akira
AU - Hasegawa, Masanori
AU - Jinzaki, Masahiro
AU - Kikuchi, Eiji
AU - Nakagawa, Ken
AU - Oya, Mototsugu
PY - 2012/12
Y1 - 2012/12
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.
KW - BMI
KW - Laparoscopy
KW - Metabolic syndrome
KW - Nephrectomy
KW - Renal cell carcinoma
KW - Visceral fat area
KW - Visceral obesity
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U2 - 10.1111/j.1464-410X.2012.11274.x
DO - 10.1111/j.1464-410X.2012.11274.x
M3 - Article
C2 - 22642302
AN - SCOPUS:84873277117
VL - 110
SP - E980-E984
JO - British Journal of Urology
JF - British Journal of Urology
SN - 1464-4096
IS - 11 C
ER -