Hand-assisted laparoscopic nephroureterectomy (HALNU): an assessment of the impact of obesity in 50 procedures
The aims of this study was to review our experience with hand-assisted laparoscopic nephroureterectomy (HALNU) and to evaluate the impact of body-mass index (BMI) on outcomes. We retrospectively analyzed 50 HALNU patients. Twenty had body mass indices (BMIs) /=30 (obese cohort). The cohorts had simi...
Gespeichert in:
| Veröffentlicht in: | Journal of laparoendoscopic & advanced surgical techniques. Part A 2008-02, Vol.18 (1), p.61-68 |
|---|---|
| Hauptverfasser: | , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 68 |
|---|---|
| container_issue | 1 |
| container_start_page | 61 |
| container_title | Journal of laparoendoscopic & advanced surgical techniques. Part A |
| container_volume | 18 |
| creator | Brown, James A Chenven, Eric Looney, Stephen W Miller, Kelly M Strup, Stephen E Bagley, Demetrius H Gomella, Leonard G |
| description | The aims of this study was to review our experience with hand-assisted laparoscopic nephroureterectomy (HALNU) and to evaluate the impact of body-mass index (BMI) on outcomes.
We retrospectively analyzed 50 HALNU patients. Twenty had body mass indices (BMIs) /=30 (obese cohort).
The cohorts had similar operative times: 349, 326, and 320 minutes, respectively. Most patients (38) underwent a total HAL distal ureterectomy, but 9 underwent an initial transurethral ureteral dissection (5 [25%], 2 [11%], and 2 [17%]). Five patients were converted to open and 1 had a planned open ureterectomy. The cystotomy was sutured closed in most but left open in 6 (3 [15%], 2 [11%], and 1 [8%]), and a stapled ureteral division was performed in 7 (3 [15%], 2 [11%], and 2 [17%]). Increased BMI was associated with delayed oral intake (P = 0.034). No significant cohort differences were observed for estimated blood loss (EBL), transfusion rate, complication rate, surgical margin status, distant metastases, or death rate. The obese cohort demonstrated trends toward increased hospitalization and bladder cancer recurrence (P = 0.083, P = 0.097). Patients with prior open surgery had longer hospitalizations (P = 0.024). Patients without prior surgery were more commonly alive with persistent disease (P = 0.027). EBL was greater for patients who had transurethral ureteral dissection (P = 0.030). Patients undergoing a stapled ureteral division had delayed oral intake, bowel function, and discharge (P = |
| doi_str_mv | 10.1089/lap.2006.0131 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70283872</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>70283872</sourcerecordid><originalsourceid>FETCH-LOGICAL-c291t-ce5c8efbbcc28fd21effe3f58bad2b7e6cc29e7182dfd75fb5a432e2da82a94d3</originalsourceid><addsrcrecordid>eNpFkD1PwzAQhi0EoqUwsiJPCIYU24ljh62qgCJVsNDZcuyzGpQvbHfov8ellbjlPvTee7oHoVtK5pTI6qnV45wRUs4JzekZmlLORVaRvDhPNalYVhasmqCrEL5JiiovLtGESlaWXIgp6le6t5kOoQkRLE5u2g_BDGNjcA_j1g87DxE8mDh0e_ywWqw_No_PWPc4LUEIHfQRDw7HLeCmG7X564YaQhP3uOkxJ3j0gwGbjMI1unC6DXBzyjO0eX35Wq6y9efb-3KxzgyraMwMcCPB1bUxTDrLKDgHueOy1pbVAso0r0CkN6yzgrua6yJnwKyWTFeFzWfo_uibTv_sIETVNcFA2-oehl1QgjCZS8GSMDsKTXo7eHBq9E2n_V5Rog6AVUKiDoDVAXDS352Md3UH9l99Ipr_Ao12eWU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>70283872</pqid></control><display><type>article</type><title>Hand-assisted laparoscopic nephroureterectomy (HALNU): an assessment of the impact of obesity in 50 procedures</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Brown, James A ; Chenven, Eric ; Looney, Stephen W ; Miller, Kelly M ; Strup, Stephen E ; Bagley, Demetrius H ; Gomella, Leonard G</creator><creatorcontrib>Brown, James A ; Chenven, Eric ; Looney, Stephen W ; Miller, Kelly M ; Strup, Stephen E ; Bagley, Demetrius H ; Gomella, Leonard G</creatorcontrib><description>The aims of this study was to review our experience with hand-assisted laparoscopic nephroureterectomy (HALNU) and to evaluate the impact of body-mass index (BMI) on outcomes.
We retrospectively analyzed 50 HALNU patients. Twenty had body mass indices (BMIs) <25 (normal cohort), 18 had BMIs between 25 and 29.9 (overweight cohort), and 12 had BMIs >/=30 (obese cohort).
The cohorts had similar operative times: 349, 326, and 320 minutes, respectively. Most patients (38) underwent a total HAL distal ureterectomy, but 9 underwent an initial transurethral ureteral dissection (5 [25%], 2 [11%], and 2 [17%]). Five patients were converted to open and 1 had a planned open ureterectomy. The cystotomy was sutured closed in most but left open in 6 (3 [15%], 2 [11%], and 1 [8%]), and a stapled ureteral division was performed in 7 (3 [15%], 2 [11%], and 2 [17%]). Increased BMI was associated with delayed oral intake (P = 0.034). No significant cohort differences were observed for estimated blood loss (EBL), transfusion rate, complication rate, surgical margin status, distant metastases, or death rate. The obese cohort demonstrated trends toward increased hospitalization and bladder cancer recurrence (P = 0.083, P = 0.097). Patients with prior open surgery had longer hospitalizations (P = 0.024). Patients without prior surgery were more commonly alive with persistent disease (P = 0.027). EBL was greater for patients who had transurethral ureteral dissection (P = 0.030). Patients undergoing a stapled ureteral division had delayed oral intake, bowel function, and discharge (P = <0.001, P = 0.034, and P = 0.034).
HALNU is an effective surgical treatment for patients with BMIs as great as 45.</description><identifier>ISSN: 1092-6429</identifier><identifier>EISSN: 1557-9034</identifier><identifier>DOI: 10.1089/lap.2006.0131</identifier><identifier>PMID: 18266577</identifier><language>eng</language><publisher>United States</publisher><subject>Aged ; Blood Loss, Surgical ; Blood Transfusion ; Body Mass Index ; Carcinoma, Transitional Cell - surgery ; Cystotomy ; Female ; Humans ; Kidney Neoplasms - surgery ; Laparoscopy ; Male ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Nephrectomy - methods ; Nephrectomy - mortality ; Obesity - complications ; Postoperative Complications ; Retrospective Studies ; Treatment Outcome ; Ureter - surgery ; Ureteral Neoplasms - surgery ; Urinary Bladder Neoplasms - surgery</subject><ispartof>Journal of laparoendoscopic & advanced surgical techniques. Part A, 2008-02, Vol.18 (1), p.61-68</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c291t-ce5c8efbbcc28fd21effe3f58bad2b7e6cc29e7182dfd75fb5a432e2da82a94d3</citedby><cites>FETCH-LOGICAL-c291t-ce5c8efbbcc28fd21effe3f58bad2b7e6cc29e7182dfd75fb5a432e2da82a94d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18266577$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Brown, James A</creatorcontrib><creatorcontrib>Chenven, Eric</creatorcontrib><creatorcontrib>Looney, Stephen W</creatorcontrib><creatorcontrib>Miller, Kelly M</creatorcontrib><creatorcontrib>Strup, Stephen E</creatorcontrib><creatorcontrib>Bagley, Demetrius H</creatorcontrib><creatorcontrib>Gomella, Leonard G</creatorcontrib><title>Hand-assisted laparoscopic nephroureterectomy (HALNU): an assessment of the impact of obesity in 50 procedures</title><title>Journal of laparoendoscopic & advanced surgical techniques. Part A</title><addtitle>J Laparoendosc Adv Surg Tech A</addtitle><description>The aims of this study was to review our experience with hand-assisted laparoscopic nephroureterectomy (HALNU) and to evaluate the impact of body-mass index (BMI) on outcomes.
We retrospectively analyzed 50 HALNU patients. Twenty had body mass indices (BMIs) <25 (normal cohort), 18 had BMIs between 25 and 29.9 (overweight cohort), and 12 had BMIs >/=30 (obese cohort).
The cohorts had similar operative times: 349, 326, and 320 minutes, respectively. Most patients (38) underwent a total HAL distal ureterectomy, but 9 underwent an initial transurethral ureteral dissection (5 [25%], 2 [11%], and 2 [17%]). Five patients were converted to open and 1 had a planned open ureterectomy. The cystotomy was sutured closed in most but left open in 6 (3 [15%], 2 [11%], and 1 [8%]), and a stapled ureteral division was performed in 7 (3 [15%], 2 [11%], and 2 [17%]). Increased BMI was associated with delayed oral intake (P = 0.034). No significant cohort differences were observed for estimated blood loss (EBL), transfusion rate, complication rate, surgical margin status, distant metastases, or death rate. The obese cohort demonstrated trends toward increased hospitalization and bladder cancer recurrence (P = 0.083, P = 0.097). Patients with prior open surgery had longer hospitalizations (P = 0.024). Patients without prior surgery were more commonly alive with persistent disease (P = 0.027). EBL was greater for patients who had transurethral ureteral dissection (P = 0.030). Patients undergoing a stapled ureteral division had delayed oral intake, bowel function, and discharge (P = <0.001, P = 0.034, and P = 0.034).
HALNU is an effective surgical treatment for patients with BMIs as great as 45.</description><subject>Aged</subject><subject>Blood Loss, Surgical</subject><subject>Blood Transfusion</subject><subject>Body Mass Index</subject><subject>Carcinoma, Transitional Cell - surgery</subject><subject>Cystotomy</subject><subject>Female</subject><subject>Humans</subject><subject>Kidney Neoplasms - surgery</subject><subject>Laparoscopy</subject><subject>Male</subject><subject>Neoplasm Metastasis</subject><subject>Neoplasm Recurrence, Local</subject><subject>Nephrectomy - methods</subject><subject>Nephrectomy - mortality</subject><subject>Obesity - complications</subject><subject>Postoperative Complications</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><subject>Ureter - surgery</subject><subject>Ureteral Neoplasms - surgery</subject><subject>Urinary Bladder Neoplasms - surgery</subject><issn>1092-6429</issn><issn>1557-9034</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkD1PwzAQhi0EoqUwsiJPCIYU24ljh62qgCJVsNDZcuyzGpQvbHfov8ellbjlPvTee7oHoVtK5pTI6qnV45wRUs4JzekZmlLORVaRvDhPNalYVhasmqCrEL5JiiovLtGESlaWXIgp6le6t5kOoQkRLE5u2g_BDGNjcA_j1g87DxE8mDh0e_ywWqw_No_PWPc4LUEIHfQRDw7HLeCmG7X564YaQhP3uOkxJ3j0gwGbjMI1unC6DXBzyjO0eX35Wq6y9efb-3KxzgyraMwMcCPB1bUxTDrLKDgHueOy1pbVAso0r0CkN6yzgrua6yJnwKyWTFeFzWfo_uibTv_sIETVNcFA2-oehl1QgjCZS8GSMDsKTXo7eHBq9E2n_V5Rog6AVUKiDoDVAXDS352Md3UH9l99Ipr_Ao12eWU</recordid><startdate>200802</startdate><enddate>200802</enddate><creator>Brown, James A</creator><creator>Chenven, Eric</creator><creator>Looney, Stephen W</creator><creator>Miller, Kelly M</creator><creator>Strup, Stephen E</creator><creator>Bagley, Demetrius H</creator><creator>Gomella, Leonard G</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200802</creationdate><title>Hand-assisted laparoscopic nephroureterectomy (HALNU): an assessment of the impact of obesity in 50 procedures</title><author>Brown, James A ; Chenven, Eric ; Looney, Stephen W ; Miller, Kelly M ; Strup, Stephen E ; Bagley, Demetrius H ; Gomella, Leonard G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c291t-ce5c8efbbcc28fd21effe3f58bad2b7e6cc29e7182dfd75fb5a432e2da82a94d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Aged</topic><topic>Blood Loss, Surgical</topic><topic>Blood Transfusion</topic><topic>Body Mass Index</topic><topic>Carcinoma, Transitional Cell - surgery</topic><topic>Cystotomy</topic><topic>Female</topic><topic>Humans</topic><topic>Kidney Neoplasms - surgery</topic><topic>Laparoscopy</topic><topic>Male</topic><topic>Neoplasm Metastasis</topic><topic>Neoplasm Recurrence, Local</topic><topic>Nephrectomy - methods</topic><topic>Nephrectomy - mortality</topic><topic>Obesity - complications</topic><topic>Postoperative Complications</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><topic>Ureter - surgery</topic><topic>Ureteral Neoplasms - surgery</topic><topic>Urinary Bladder Neoplasms - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Brown, James A</creatorcontrib><creatorcontrib>Chenven, Eric</creatorcontrib><creatorcontrib>Looney, Stephen W</creatorcontrib><creatorcontrib>Miller, Kelly M</creatorcontrib><creatorcontrib>Strup, Stephen E</creatorcontrib><creatorcontrib>Bagley, Demetrius H</creatorcontrib><creatorcontrib>Gomella, Leonard G</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of laparoendoscopic & advanced surgical techniques. Part A</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brown, James A</au><au>Chenven, Eric</au><au>Looney, Stephen W</au><au>Miller, Kelly M</au><au>Strup, Stephen E</au><au>Bagley, Demetrius H</au><au>Gomella, Leonard G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hand-assisted laparoscopic nephroureterectomy (HALNU): an assessment of the impact of obesity in 50 procedures</atitle><jtitle>Journal of laparoendoscopic & advanced surgical techniques. Part A</jtitle><addtitle>J Laparoendosc Adv Surg Tech A</addtitle><date>2008-02</date><risdate>2008</risdate><volume>18</volume><issue>1</issue><spage>61</spage><epage>68</epage><pages>61-68</pages><issn>1092-6429</issn><eissn>1557-9034</eissn><abstract>The aims of this study was to review our experience with hand-assisted laparoscopic nephroureterectomy (HALNU) and to evaluate the impact of body-mass index (BMI) on outcomes.
We retrospectively analyzed 50 HALNU patients. Twenty had body mass indices (BMIs) <25 (normal cohort), 18 had BMIs between 25 and 29.9 (overweight cohort), and 12 had BMIs >/=30 (obese cohort).
The cohorts had similar operative times: 349, 326, and 320 minutes, respectively. Most patients (38) underwent a total HAL distal ureterectomy, but 9 underwent an initial transurethral ureteral dissection (5 [25%], 2 [11%], and 2 [17%]). Five patients were converted to open and 1 had a planned open ureterectomy. The cystotomy was sutured closed in most but left open in 6 (3 [15%], 2 [11%], and 1 [8%]), and a stapled ureteral division was performed in 7 (3 [15%], 2 [11%], and 2 [17%]). Increased BMI was associated with delayed oral intake (P = 0.034). No significant cohort differences were observed for estimated blood loss (EBL), transfusion rate, complication rate, surgical margin status, distant metastases, or death rate. The obese cohort demonstrated trends toward increased hospitalization and bladder cancer recurrence (P = 0.083, P = 0.097). Patients with prior open surgery had longer hospitalizations (P = 0.024). Patients without prior surgery were more commonly alive with persistent disease (P = 0.027). EBL was greater for patients who had transurethral ureteral dissection (P = 0.030). Patients undergoing a stapled ureteral division had delayed oral intake, bowel function, and discharge (P = <0.001, P = 0.034, and P = 0.034).
HALNU is an effective surgical treatment for patients with BMIs as great as 45.</abstract><cop>United States</cop><pmid>18266577</pmid><doi>10.1089/lap.2006.0131</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1092-6429 |
| ispartof | Journal of laparoendoscopic & advanced surgical techniques. Part A, 2008-02, Vol.18 (1), p.61-68 |
| issn | 1092-6429 1557-9034 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_70283872 |
| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Aged Blood Loss, Surgical Blood Transfusion Body Mass Index Carcinoma, Transitional Cell - surgery Cystotomy Female Humans Kidney Neoplasms - surgery Laparoscopy Male Neoplasm Metastasis Neoplasm Recurrence, Local Nephrectomy - methods Nephrectomy - mortality Obesity - complications Postoperative Complications Retrospective Studies Treatment Outcome Ureter - surgery Ureteral Neoplasms - surgery Urinary Bladder Neoplasms - surgery |
| title | Hand-assisted laparoscopic nephroureterectomy (HALNU): an assessment of the impact of obesity in 50 procedures |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-07T20%3A45%3A25IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Hand-assisted%20laparoscopic%20nephroureterectomy%20(HALNU):%20an%20assessment%20of%20the%20impact%20of%20obesity%20in%2050%20procedures&rft.jtitle=Journal%20of%20laparoendoscopic%20&%20advanced%20surgical%20techniques.%20Part%20A&rft.au=Brown,%20James%20A&rft.date=2008-02&rft.volume=18&rft.issue=1&rft.spage=61&rft.epage=68&rft.pages=61-68&rft.issn=1092-6429&rft.eissn=1557-9034&rft_id=info:doi/10.1089/lap.2006.0131&rft_dat=%3Cproquest_cross%3E70283872%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=70283872&rft_id=info:pmid/18266577&rfr_iscdi=true |