Background <p>Surgeons may experience technical complexity and negative outcomes related to robotic liver surgery (RLS) in obese patients. However, evidence regarding the impact of obesity on perioperative outcomes in RLS is limited.</p> Methods <p>A retrospective analysis was performed on patients who underwent RLS between 2019 and 2024. Obesity was defined as a BMI ≥ 30&#xa0;kg/m<sup>2</sup>, and postoperative complication rate and risk factors were evaluated for complications. Short-term perioperative outcomes were compared using propensity score matching (PSM) analysis at a 1:1 ratio.</p> Results <p>A total of 205 RLS procedures were performed at a high-volume hepatopancreatobiliary (HPB) center in Denmark. After 1:1 propensity score matching, 41 patients in each group were included. In the obese group, the rate of comorbid diabetes (<i>p</i> = 0.037) and the rate of steatosis (<i>p</i> = 0.035) were significantly higher in the obese group; standard liver volumes were also significantly larger (<i>p</i> &lt; 0.001). There was no significant difference in the rate of major complications or the rate of all complications between the two groups. In multivariate binary logistic regression analysis using the nine factors selected in univariate analysis, only the IWATE criteria (≥ 7) showed a nearly significant p-value [<i>p</i> = 0.056], potentially suggesting an association with major postoperative complications.</p> Conclusions <p>The results of our single-center experience demonstrated that RLS in patients with a BMI of 30 or more did not impact postoperative surgical complications or other short-term outcomes. Therefore, RLS appears safe and feasible for obese patients in experienced centers.</p>

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The impact of body mass index on short-term surgical outcomes after robotic liver surgery: a propensity-score matched analysis at a high-volume center in Denmark

  • Fukumori Daisuke,
  • Takashi Hamada,
  • Christoph Tschuor,
  • Jens Hillingsø,
  • Peter Nørgaard Larsen

摘要

Background

Surgeons may experience technical complexity and negative outcomes related to robotic liver surgery (RLS) in obese patients. However, evidence regarding the impact of obesity on perioperative outcomes in RLS is limited.

Methods

A retrospective analysis was performed on patients who underwent RLS between 2019 and 2024. Obesity was defined as a BMI ≥ 30 kg/m2, and postoperative complication rate and risk factors were evaluated for complications. Short-term perioperative outcomes were compared using propensity score matching (PSM) analysis at a 1:1 ratio.

Results

A total of 205 RLS procedures were performed at a high-volume hepatopancreatobiliary (HPB) center in Denmark. After 1:1 propensity score matching, 41 patients in each group were included. In the obese group, the rate of comorbid diabetes (p = 0.037) and the rate of steatosis (p = 0.035) were significantly higher in the obese group; standard liver volumes were also significantly larger (p < 0.001). There was no significant difference in the rate of major complications or the rate of all complications between the two groups. In multivariate binary logistic regression analysis using the nine factors selected in univariate analysis, only the IWATE criteria (≥ 7) showed a nearly significant p-value [p = 0.056], potentially suggesting an association with major postoperative complications.

Conclusions

The results of our single-center experience demonstrated that RLS in patients with a BMI of 30 or more did not impact postoperative surgical complications or other short-term outcomes. Therefore, RLS appears safe and feasible for obese patients in experienced centers.