Related Experiment Video
Updated: Feb 6, 2026
Single Port Donor Nephrectomy
Published on: March 12, 2011
Obesity and 30-Day Outcomes Following Minimally Invasive Nephrectomy
Colin D Sperling1, Leilei Xia2, Ian B Berger3
1Cooper Medical School of Rowan University, Camden, NJ; Division of Urology, Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Objective:
To evaluate the association between obesity and postoperative outcomes following minimally invasive partial nephrectomy (MIPN) and minimally invasive radical nephrectomy (MIRN).
Methods:
Using the National Surgical Quality Improvement Project database, we identified adult patients who underwent either MIPN or MIRN from 2012 to 2016. Patients were stratified by body mass index (BMI) according the World Health Organization classification of obesity (nonobese [BMI 18.5-29.9 kg/m2], class I obesity [BMI 30-34.9 kg/m2], class II obesity [BMI 35-39.9 kg/m2], and class III obesity [BMI≥40 kg/m2]). Multivariable logistic regressions alternately including obesity class, comorbidity score, and both were used to evaluate the association among these variables with post-operative outcomes.
Results:
A total of 21,334 patients (MIPN=10,444, MIRN=10,890) were included. When only obesity class or comorbidity score was included in our multivariable logistic regression model, both variables were associated with increased odds of overall 30-day complications. However, when both class or comorbidity were included in the model, comorbidity but not obesity was found to be associated with increased postoperative complications. Obesity was also not found to be associated with unplanned readmission. However, obesity was independently associated with prolonged operative time and discharge to continued care in the full model.
Conclusion:
This NSQIP study suggests that BMI does not independently predict the likelihood of overall complications or readmission within 30 days, and should not be considered a major barrier for MIPN or MIRN. Instead, obesity should be taken into consideration with other comorbidities when risk-stratifying patients prior to minimally invasive nephrectomy.
Insights
Obesity does not independently predict 30-day complications or readmission after minimally invasive nephrectomy. However, it is associated with longer operative times and discharge to continued care, warranting consideration alongside comorbidities.
Area of Science:
- Urology
- Surgical Outcomes
- Nephrology
Background:
- Minimally invasive partial nephrectomy (MIPN) and radical nephrectomy (MIRN) are standard procedures.
- The impact of obesity on outcomes after these procedures requires further clarification.
Purpose of the Study:
- To evaluate the association between obesity and postoperative outcomes following MIPN and MIRN.
- To determine if body mass index (BMI) independently predicts complications or readmissions.
Main Methods:
- Analysis of the National Surgical Quality Improvement Project database (2012-2016).
- Stratification of adult patients by BMI into obesity classes (nonobese, class I, II, III).
- Multivariable logistic regression models to assess associations between obesity, comorbidity score, and outcomes.
Main Results:
- Comorbidity score, but not obesity class alone, was associated with increased 30-day postoperative complications when both were in the model.
- Obesity was not associated with unplanned readmission.
- Obesity was independently linked to prolonged operative time and discharge to continued care.
Conclusions:
- BMI alone does not independently predict overall complications or 30-day readmission after MIPN or MIRN.
- Obesity should be considered with other comorbidities for risk stratification before minimally invasive nephrectomy.
- Obesity is not a definitive contraindication for these procedures.
Related Concept Videos
01:24Obesity
02:24Predicting Reaction Outcomes
01:13Outcomes of Glycolysis
Cellular respiration can occur aerobically (with oxygen) or anaerobically (without oxygen). In the presence of oxygen, cellular respiration starts with glycolysis and continues with pyruvate...
01:11Guidelines for Writing Outcome
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care...
01:21Drug Dosing: Obese Patients
01:25Pharmacokinetics in Obese Patients: Drug Absorption and Distribution