Robot-assisted partial nephrectomy (RAPN) is a safe and feasible option for managing renal cell carcinoma (RCC) in obese patients, according to data from a recent study.
Obesity has been confirmed as a risk factor for RCC, the authors stated, noting that medical factors such as hypertension, diabetes mellitus, and chronic kidney disease are more common in obese patients and may cause worsening of renal function over time.
The study, by Craig Rogers, MD, and colleagues at the Vattikuti Urology Institute, Henry Ford Hospital, Detroit, involved 97 patients who underwent RAPN. Of these, 49 were obese and 48 were non-obese. Obese subjects had an average BMI of 36.2 kg/m2 versus 25.7 kg/m2 for non-obese patients.
RAPN was associated with comparable outcomes in both groups. Although obese patients had a higher estimated blood loss than non-obese subjects (150 vs. 100 mL), longer operative time (265.0 vs. 242.5 minutes), and longer warm ischemia time (26.5 vs. 22.5 minutes), these differences did not achieve statistical significance, the authors reported in the Journal of Endourology (2011;25:101-105). The post-operative complication rate in the obese and non-obese groups was 8.3% and 4.3%, respectively, but the difference was not statistically significant.
“We do not necessarily advocate robotic assistance for all obese patients undergoing partial nephrectomy, but robotic assistance may help some obese patients to achieve the convalescence benefits of minimally invasive partial nephrectomy,” the investigators concluded. “Robotic assistance may also help overcome technical challenges of LPN in obese patients.”