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World Journal of Surgery
Erschienen in: World Journal of Surgery 12/2010

01.12.2010

Safety of Liver Resections in Obese and Overweight Patients

verfasst von: Silvio Balzan, Ganesh Nagarajan, Olivier Farges, Claudio Zettler Galleano, Safi Dokmak, Catherine Paugam, Jacques Belghiti

Erschienen in: World Journal of Surgery | Ausgabe 12/2010

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Abstract

Background

The new global epidemic, overweight and obesity, has a significant role in the etiology of liver tumors. However, the impact of body weight on the outcome after liver resection is unknown.

Methods

We carried out a prospective study of 684 patients who underwent liver resections. Patients were stratified according their body mass index (BMI) as follows: normal (<25 kg/m2) (52%), overweight (25–29 kg/m2) (34%), and obese (≥30 kg/m2) (14%), and according to the extent of resection, as either minor or major hepatectomy. Preoperative and intraoperative characteristics and outcomes were prospectively studied. The Dindo–Clavien classification of morbidity was used.

Results

Overall postoperative morbidity and morbidity rates were not influenced by BMI. Pulmonary complications were significantly more frequent in obese patients irrespective of the extent of resection. During major resection obese had longer pedicular clamping and more frequently required blood transfusion. After major resection, major morbidity (Dindo–Clavien grade III or more) was more frequent in obese (57%) and overweight (54%) patients than in patients of normal body weight (35%; P < 0.05), including a higher rate of respiratory complications and ascites and longer intensive care unit (ICU) and hospital stays. Obesity and overweight were independent predictors of major morbidity (OR 2.6, 95% CI 1.2–5.8 and OR 1.9, 95% CI 1.2–3.2, respectively), and obesity was a predictor of the need for blood transfusion (OR 3.3, 95% CI 1.4–7.9) after major resections.

Conclusions

Obese and overweight patients are at increased risk of potentially life-threatening morbidity after major hepatic resections. Because the risk of mortality is not increased significantly, there is no justification for a compromise in the indication or extent of surgery.
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Metadaten
Titel
Safety of Liver Resections in Obese and Overweight Patients
verfasst von
Silvio Balzan
Ganesh Nagarajan
Olivier Farges
Claudio Zettler Galleano
Safi Dokmak
Catherine Paugam
Jacques Belghiti
Publikationsdatum
01.12.2010
Verlag
Springer-Verlag
Erschienen in
World Journal of Surgery / Ausgabe 12/2010
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-010-0756-1

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