Positive impact of laparoscopic hepatectomy versus open hepatectomy on body size-corrected bleeding in obese patients.

IF 1.7 4区医学 Q2 SURGERY Surgery Today Pub Date : 2024-12-01 Epub Date: 2024-06-14 DOI:10.1007/s00595-024-02865-3

Masanori Nakamura, Ryo Ashida, Katsuhisa Ohgi, Mihoko Yamada, Yoshiyasu Kato, Shimpei Otsuka, Yuko Kakuda, Katsuhiko Uesaka, Teiichi Sugiura

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Abstract

Purpose: Laparoscopic hepatectomy (LH) is reported to cause less bleeding than open hepatectomy (OH) in obese patients; however, there are no reports addressing this issue in terms of body size-corrected bleeding.

Methods: The subjects of this study were 31 obese and 149 non-obese patients who underwent LH and 32 obese and 245 non-obese patients who underwent OH. Bleeding corrected for body surface area (C-BL) was compared between the obese and non-obese patients who underwent each procedure. A multivariate analysis for increased C-BL was performed using the median C-BL for each procedure.

Results: The median C-BL tended to be higher in the obese patients than in the non-obese patients who underwent LH, but there was no significant difference (72 vs. 42 mL/m², P = 0.050). However, it was significantly higher in the obese patients than in the non-obese patients who underwent OH (542 vs. 333 mL/m², P = 0.002). In a multivariate analysis, for OH, sectionectomy or more (OR 3.20, P < 0.001) and a high BMI (OR 2.76, P = 0.018) were found to be independent risk factors, whereas for LH, a high BMI was not (OR 1.58, P = 0.301).

Conclusions: Obesity was identified as a risk factor for increased bleeding with body size correction for OH, but the risk was reduced for LH.

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腹腔镜肝切除术与开腹肝切除术对肥胖患者体型校正出血量的积极影响。

目的：据报道，腹腔镜肝切除术（LH）与开腹肝切除术（OH）相比，可减少肥胖患者的出血量；但是，目前还没有关于体型校正出血量的报告：研究对象：31 名肥胖患者和 149 名非肥胖患者接受了 LH 手术，32 名肥胖患者和 245 名非肥胖患者接受了 OH 手术。比较了接受两种手术的肥胖和非肥胖患者按体表面积校正的出血量（C-BL）。使用每种手术的 C-BL 中位数对 C-BL 增加情况进行了多变量分析：结果：接受 LH 手术的肥胖患者的 C-BL 中位数往往高于非肥胖患者，但没有显著差异（72 对 42 mL/m2，P = 0.050）。不过，肥胖患者的血流阻力明显高于接受OH治疗的非肥胖患者（542 mL/m2 对 333 mL/m2，P = 0.002）。在一项多变量分析中，OH、切口切除术或更多切口切除术（OR 3.20，P 结论：肥胖被认为是一种危险因素，因为肥胖会导致膀胱癌：肥胖被认为是OH手术体型校正后出血增加的风险因素，但LH手术的风险有所降低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.