Laparoscopic partial nephrectomy in obese and non-obese patients: comparison with open surgery.

Objectives The aim of this study was to compare the perioperative outcomes of open (OPN) and laparoscopic (LPN) partial nephrectomy in obese and non-obese patients. Methods We analyzed records for a cohort of 56 patients (28 obese and 28 non-obese) who underwent OPN, as well as 112 (56 obese and 56 non-obese) who underwent LPN. Results Obese patients undergoing OPN had increased operative time (285.9 ± 69.7 versus 195.2 ± 59.8 minutes), blood loss (484.5 ± 272.1 versus 391.7 ± 308.6 mL), clamp time (44.4 ± 12.8 versus 28.2 ± 10.5 minutes), intraoperative complications (14.3% versus 1.8%), postoperative complications (35.7% versus 17.9%), and hospital stay (6.4 ± 2.8 versus 3.2 ± 2.2 days) than those undergoing LPN. Comparison of obese versus non-obese patients who underwent LPN revealed similar perioperative outcomes, with the exception of a greater blood loss in the obese patient cohort (391.7 ± 308.6 versus 280.9 ± 202.1 mL). Finally, in comparing perioperative data among non-obese patients who underwent OPN versus LPN, those who underwent LPN were found to have improved operative times (248.9 ± 45.0 versus 181.1 ± 62.4 minutes), less blood loss (412.4 ± 274.6 versus 280.9 ± 202.1 mL), fewer intraoperative complications (21.4% versus 1.8%), and shorter length of hospital stay (6.3 ± 2.8 versus 3.2 ± 1.6 days). Conclusions Laparoscopic partial nephrectomy has significantly better perioperative outcomes than open partial nephrectomy in both the obese and non-obese populations.