Universität zu Köln

Bulian, Dirk R., Knuth, Jurgen, Thomaidis, Panagiotis, Rieger, Anna, Seefeldt, Claudia Simone, Lange, Jonas, Meyer, Jurgen, Stroehlein, Michael A. and Heiss, Markus M. (2018). Does obesity influence the results in Transvaginal Hybrid-NOTES cholecystectomy? Surg. Endosc., 32 (11). S. 4632 - 4639. NEW YORK: SPRINGER. ISSN 1432-2218

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Abstract

BackgroundMorbidly obese patients are usually excluded from studies that compare Transvaginal Hybrid-NOTES Cholecystectomy (TVC) with traditional laparoscopic cholecystectomy. Therefore, these study results cannot necessarily be transferred to this group of patients. In this study, we have analyzed and compared the outcomes of the procedure with obese and non-obese patients.MethodsData from a prospectively maintained database were retrospectively analyzed. All the TVCs performed in our clinic since 2008 were divided into groups according to their body mass index (BMI). Within these groups, we evaluated the following outcome parameters: age, ASA classification, procedural time, number of percutaneous trocars, intra- and postoperative complications, and postoperative hospital stay. Additionally, the posthospital surgical and gynecological follow-up was evaluated for additional complications and patients with class III obesity were contacted to determine further parameters.ResultsSix underweight, 76 normal weight, 72 overweight, 48 class I obesity, 15 class II obesity, and 20 class III obesity patients were analyzed. ASA classification (P<0.001), procedural time (P<0.001), and number of percutaneous trocars (P<0.001) significantly increased with the BMI. By contrast, intra- and postoperative complications (P=0.134 and P=0.571), as well as postoperative hospital stay (P=0.076) did not depend on the BMI. Neither did the classification according to Clavien/Dindo show a significant relation (P=0.640). Lethality was zero. All posthospital gynecological follow-ups were inconspicuous. Telephone follow-up of class III obesity patients reached a rate of 85% after median 3.4years. There were no additional complications or problems during sexual intercourse. The satisfaction with the cosmetic and the overall result was very high.ConclusionsAlthough the results of existing studies including normal-weight or merely moderately obese patients can hardly be applied to morbidly obese patients, especially regarding procedural time and the number of percutaneous trocars, obesity should not be an exclusion criterion for TVC, regardless of its magnitude.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bulian, Dirk R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Knuth, Jurgen UNSPECIFIED UNSPECIFIED UNSPECIFIED Thomaidis, Panagiotis UNSPECIFIED UNSPECIFIED UNSPECIFIED Rieger, Anna UNSPECIFIED UNSPECIFIED UNSPECIFIED Seefeldt, Claudia Simone UNSPECIFIED UNSPECIFIED UNSPECIFIED Lange, Jonas UNSPECIFIED UNSPECIFIED UNSPECIFIED Meyer, Jurgen UNSPECIFIED UNSPECIFIED UNSPECIFIED Stroehlein, Michael A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heiss, Markus M. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-168423
DOI:	10.1007/s00464-018-6216-y
Journal or Publication Title:	Surg. Endosc.
Volume:	32
Number:	11
Page Range:	S. 4632 - 4639
Date:	2018
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-2218
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CONVENTIONAL LAPAROSCOPIC CHOLECYSTECTOMY; RANDOMIZED CLINICAL-TRIAL; POSTOPERATIVE PAIN; METAANALYSIS; COHORT; OUTCOMES; DISEASE; SAFETY Multiple languages Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16842