An obese body habitus does not preclude a minimally invasive partial nephrectomy

Area of Science:

• Urology
• Surgical Oncology
• Nephrology

Background:

• Partial nephrectomy (PN) is standard for renal cell carcinoma (RCC) when feasible.
• Outcomes of minimally invasive partial nephrectomy (MIPN) in obese patients require further definition.
• This study evaluates MIPN feasibility in obesity classes I-III compared to lower BMI.

Purpose of the Study:

• To assess the safety and efficacy of MIPN in patients with varying degrees of obesity.
• To compare surgical outcomes of MIPN between obese and non-obese patient cohorts.
• To identify factors associated with perioperative complications in MIPN.

Main Methods:

• Retrospective review of 184 patients undergoing laparoscopic or robotic MIPN.
• Patients stratified into four BMI groups: <30, 30-35 (Class I), 35-40 (Class II), >40 (Class III).
• Analysis of perioperative and pathologic outcomes, including operative time, ischemia duration, EBL, and complications.

Main Results:

• No significant difference in perioperative or pathologic outcomes was observed between obese and non-obese patients.
• Obesity class or degree of obesity did not correlate with adverse surgical outcomes.
• Higher RENAL nephrometry score (≥8) was the only significant predictor of complications (HR 5.1).

Conclusions:

• Obesity classification is not associated with adverse outcomes after MIPN for RCC.
• MIPN is a viable option for obese patients with RCC.
• RENAL nephrometry score is a critical factor in predicting complications, not patient BMI.