Relationship Between Body Mass Index and Robotic Surgery Outcomes of Women Diagnosed With Endometrial Cancer

2011 ◽  
Vol 21 (4) ◽  
pp. 722-729 ◽  
Author(s):  
Susie Lau ◽  
Karen Buzaglo ◽  
Zvi Vaknin ◽  
Sonya Brin ◽  
Rebecca Kaufer ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Endometrial Cancer ◽  
Robotic Surgery ◽  
Body Mass ◽  
Invasive Surgery ◽  
Minimal Invasive Surgery ◽  
Minimal Invasive ◽  
The Body ◽  
Wound Complications ◽  
Morbidly Obese

Objective:This is a prospective evaluation of the outcome of minimal invasive surgery using robotics in function of the body mass index (BMI) of patients.Methods:This is a prospective cohort study of consecutive women undergoing surgery for endometrial cancer at a tertiary care facility since the initiation of a robotic program in December 2007. Surgical and personal outcome variables as well as quality of life and postoperative recovery were assessed using a combination of objective and subjective/self-report questionnaires. Women were divided into 3 groups based on their BMI. Comparative analyses among nonobese (n = 52), obese (n = 33) and morbidly obese (n = 23) women were performed on the outcome measures after surgery.Results:The mean BMI and the range in each of the BMI categories was 25 kg/m2 (18.7-29.4 kg/m2), 34 kg/m2 (30.1-38.4 kg/m2), and 46 kg/m2 (40.0-58.8 kg/m2). Women with higher BMI tended to be more frequently affected with comorbidities such as diabetes (15.4%, 26.0%, and 27.3%, respectively; P = 0.32) and hypertension (55.8%, 69.6%, and 69.7%, respectively; P = 0.19). Despite these differences, surgical console time (P = 0.20), major postoperative complications (P = 0.52), overall wound complications (P = 0.18), and median length of hospitalization in days (P = 0.17) were not statistically different among the 3 groups. Only 5.6% of women needed a mini laparotomy all of which were performed for the removal of their enlarged uterus, which could not be delivered safely via the vagina, at the end of the surgical procedure. There was no increased conversion to laparotomy due to increased BMI. Women in all 3 groups reported rapid resumption of hygiene regimens and chores, little need for narcotic analgesia, and high satisfaction with the procedure.Conclusions:Obese and morbidly obese patients with endometrial cancer are also good candidates for robotic surgery. These women benefit considerably from minimal invasive surgery and have little perioperative complications.

Anaesthetic Management of a Super Morbid Obese Patient

2021 ◽  
Vol 8 (32) ◽  
pp. 3039-3042
Author(s):  
Lekshmi Raj Jalaja ◽  
Stuti Lohia ◽  
Priyadarsini Bentur ◽  
Ravi Ramgiri
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Recovery Period ◽  
Well Being ◽  
Anaesthetic Management ◽  
The Body ◽  
World Health ◽  
Morbidly Obese ◽  
Multisystem Disorder ◽  
Increased Risk

‘Obesity’ is defined as a condition with excess body fat to the extent that health and well-being are adversely affected and uses a class system based on the body mass index (BMI), by the world health organization (WHO). Anaesthetic management of morbidly obese is challenging, as there is an increased risk of perioperative respiratory insufficiency and supplemental oxygen must be given throughout recovery period. The incidence of morbid obesity continues to grow and anaesthesiologists are exposed to obese patients presenting for various procedures. The prevalence of obesity is on the upward trend worldwide. Obesity is a multisystem disorder, involving the respiratory and cardiovascular systems, and therefore, undergoing a surgical procedure under anaesthesia may entail a considerable risk. Thus, a multidisciplinary approach is required in treating such patients. Quantification of the extent of obesity is done using the body mass index. BMI is defined as the relationship between weight and height (weight [kg] / height2 [m2 ]).

scholarly journals Does Body Mass Index Affect Mortality in Coronary Surgery?

2016 ◽  
Vol 10 (1) ◽  
pp. 240-245 ◽  
Author(s):  
Aristotle D. Protopapas
Keyword(s):  
Body Mass Index ◽  
Morbid Obesity ◽  
Body Mass ◽  
Artery Bypass ◽  
Normal Weight ◽  
The Body ◽  
Morbidly Obese ◽  
Coronary Surgery ◽  
Crude Mortality ◽  
Underweight Patients

Introduction: The Body Mass Index (BMI) quantifies nutritional status and classifies humans as underweight, of normal weight, overweight, mildly obese, moderately obese or morbidly obese. Obesity is the excessive accumulation of fat, defined as BMI higher than 30 kg/m2. Obesity is widely accepted to complicate anaesthesia and surgery, being a risk factor for mediastinitis after coronary artery bypass grafting (CABG). We sought the evidence on operative mortality of CABG between standard BMI groups. Materials and Methodology: A simple literature review of papers presenting the mortality of CABG by BMI group: Underweight (BMI ≤ 18.49 kg/m2), normal weight (BMI 18.5–24.9 kg/m2), overweight (BMI 25.0–29.9 kg/m2), mild obesity (BMI 30.0–34.9 kg/m2), moderate obesity (BMI 35.0–39.9 kg/m2), or morbid obesity (BMI ≥ 40.0 kg/m2). Results: We identified 18 relevant studies with 1,027,711 patients in total. Their variability in size of samples and choice of BMI groups precluded us from attempting inferential statistics. The overall cumulative mortality was 2.7%. Underweight patients had by far the highest mortality (6.6%). Overweight patients had the lowest group mortality (2.1%). The group mortality for morbidly obese patients was 3.44%. Discussion: Patients with extreme BMI’s undergoing CABG (underweight ones more than morbidly obese) suffer increased crude mortality. This simple observation indicates that under nutrition and morbid obesity need be further explored as risk factors for coronary surgery.

scholarly journals MEDIUM-TERM FOLLOW-UP RESULTS WITH LAPAROSCOPIC SLEEVE GASTRECTOMY

2015 ◽  
Vol 28 (suppl 1) ◽  
pp. 61-64 ◽  
Author(s):  
Almino Cardoso RAMOS ◽  
Eduardo Lemos de Souza BASTOS ◽  
Manoela Galvão RAMOS ◽  
Nestor Tadashi Suguitani BERTIN ◽  
Thales Delmondes GALVÃO ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Sleeve Gastrectomy ◽  
Surgical Treatment ◽  
Surgical Technique ◽  
Body Mass ◽  
The Body ◽  
Morbidly Obese ◽  
Medium Term ◽  
Orthopedic Diseases

Background : The indications for sleeve gastrectomy in the surgical treatment of morbid obesity have increased worldwide. Despite this, several aspects related to results at medium and long term remain in constant research. Aim : To present the experience of sleeve gastrectomy in a center of excellence in bariatric surgery by analyzing clinical outcomes, complications and follow-up in the medium term. Methods : The study included 120 morbidly obese patients who underwent sleeve gastrectomy and who were followed for at least 24 months. Aspects related to surgical technique, surgical complications and clinical outcome were analyzed. Results : Seventy-five patients were women (62.5%) and the average age was 36 years. The body mass index preoperatively ranged from 35.5 to 58 kg/m2(average of 40.2 kg/m2). The length of stay ranged from 1 to 4 days (mean 2.1 days). Comorbidities observed were hypertension (19%), type 2 diabetes mellitus (6.6%), dyslipidemia (7.5%), sleep apnea (16.6%), reflux esophagitis (10%) and orthopedic diseases (7.5%). The mean body mass index and total weight loss percentage with 3, 12, 18 and 24 months were 32.2 kg/m2-19,9%; 29.5 kg/m2-26,5%; 28.2 kg/m2-30,3% and 26.9 kg/m2-32,7%, respectively. Remission of diabetes and dyslipidemia occurred in all patients. In relation to hypertension, there was improvement or remission in 86%. There were only two complications (bronchial pneumonia and dehydration), with good response to clinical treatment. There was no evidence digestive fistula and mortality was zero. Eleven patients (9.1%) had regained weighing more than 5 kg. Conclusion : The sleeve gastrectomy is surgical technique that has proven safe and effective in the surgical treatment of obesity and control of their comorbidities in postoperative follow-up for two years.

scholarly journals Can Teamwork and High-Volume Experience Overcome Challenges of Lymphadenectomy in Morbidly Obese Patients (Body Mass Index of 40 kg/m2 or Greater) with Endometrial Cancer?: A Cohort Study of Robotics and Laparotomy and Review of Literature

2018 ◽  
Vol 28 (5) ◽  
pp. 959-966 ◽  
Author(s):  
Hubert Fornalik ◽  
Temeka Zore ◽  
Nicole Fornalik ◽  
Todd Foster ◽  
Adrian Katschke ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Endometrial Cancer ◽  
Cohort Study ◽  
Robotic Surgery ◽  
Surgical Outcomes ◽  
High Volume ◽  
Surgical Staging ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Robotic Group

ObjectiveThis study aimed to compare surgical outcomes and the adequacy of surgical staging in morbidly obese women with a body mass index (BMI) of 40 kg/m2 or greater who underwent robotic surgery or laparotomy for the staging of endometrioid-type endometrial cancer.MethodsThis is a retrospective cohort study of patients who underwent surgical staging between May 2011 and June 2014. Patients' demographics, surgical outcomes, intraoperative and postoperative complications, and pathological outcomes were compared.ResultsSeventy-six morbidly obese patients underwent robotic surgery, and 35 underwent laparotomy for surgical staging. Robotic surgery was associated with more lymph nodes collected with increasing BMI (P < 0.001) and decreased chances for postoperative respiratory failure and intensive care unit admissions (P = 0.03). Despite a desire to comprehensively stage all patients, we performed successful pelvic and paraaortic lymphadenectomy in 96% versus 89% (P = 0.2) and 75% versus 60% (P = 0.12) of robotic versus laparotomy patients, respectively. In the robotic group, with median BMI of 47 kg/m2, no conversions to laparotomy occurred. The robotic group experienced less blood loss and a shorter length of hospital stay than the laparotomy group; however, the surgeries were longer.ConclusionsIn a high-volume center, a high rate of comprehensive surgical staging can be achieved in patients with BMI of 40 kg/m2 or greater either by laparotomy or robotic approach. In our experience, robotic surgery in morbidly obese patients is associated with better quality staging of endometrial cancer. With a comprehensive approach, a professional bedside assistant, use of a monopolar cautery hook, and our protocol of treating morbidly obese patients, robotic surgeries can be safely performed in the vast majority of patients with a BMI of 40 kg/m2 or greater, with lymph node counts being similar to nonobese patients, and with conversions to laparotomy reduced to a minimum.

scholarly journals OBSERVED EFFECTS OF BODY MASS INDEX ON BLOOD PRESSURE DIPPING PATTERN, IN A PRIVATE HOSPITAL IN ABUJA, NIGERIA

2021 ◽  
Vol 2 (2) ◽  
pp. 128-135
Author(s):  
O. C. Anya ◽  
O. Odugbemi ◽  
E. Okojie ◽  
R. Ayantayo ◽  
E. Ajayi
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Body Mass ◽  
Blood Pressure Monitoring ◽  
Adult Population ◽  
High Body Mass Index ◽  
The Body ◽  
Morbidly Obese ◽  
Night Time ◽  
Nighttime Blood Pressure

During a normal 24-hour ambulatory blood pressure monitoring (ABPM), there should be a more than 10% drop in average nighttime blood pressure (BP), compared to the average daytime BP. This is called the normal ABPM dipping pattern. Abnormal dipping patterns occur when the average night-time blood pressure drop is lower than 10%. A high body mass index has been described as a contributing factor for unusual ABPM dipping patterns, which predisposes an individual to a higher likelihood of developing cardiovascular disease. The goal of this research was to assess the link between the body mass index (BMI) and the dipping pattern during ABPM in the adult population who underwent ABPM at Cardiocare Abuja. Anthropometric data from 100 patients who had done ABPM were used, together with data obtained from the CONTEC ABPM50 device. The BMI was calculated with the weight and height, and they were grouped into weight classes using their BMI. The proportions of the various dipping patterns were then determined within each class. Majority of the participants involved in the study had BMI between 30-39 kg/m2. Those who presented with higher BMI classes were also discovered to have unusual dipping patterns, indicating a link with relation to the BMI and the ABPM dipping pattern. In the morbidly obese class, with BMI >40 kg/m2 there was a trend of the reverse dipping. It concluded that ABPM should be done routinely for persons with a high BMI for early detection of unusual dipping patterns and prompt intervention.

scholarly journals PSU30 EQUITY OF ACCESS TO MINIMAL INVASIVE SURGERY FOR WOMEN WITH ENDOMETRIAL CANCER

2019 ◽  
Vol 22 ◽  
pp. S897
Author(s):  
E.L. Moss ◽  
G. Morgan ◽  
A. Martin ◽  
P. Sarhanis ◽  
T. Ind
Keyword(s):  
Endometrial Cancer ◽  
Invasive Surgery ◽  
Minimal Invasive Surgery ◽  
Minimal Invasive ◽  
Equity Of Access
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