The impact of obesity on laparoscopic radical prostatectomy

Abstract

To investigate the effect of obesity on the operative variables of patients undergoing laparoscopic radical prostatectomy (LRP). The database entries and case-notes of 532 consecutive patients undergoing LRP from March 2000 to August 2005 were examined retrospectively. Complete data were available on 505 (95%) patients, 108 (21%) of whom were obese (body mass index, BMI, > or = 30 kg/m2). All patients had clinical stage T < or = 3aN0M0 prostate cancer and had their procedure done or supervised by the same surgeon. The patients' prostate-specific antigen level, Gleason score, clinical stage and prostate weight were similar. The mean values for patients deemed not obese and obese were: for operative duration (182 and 197 min, P = 0.01), blood loss (310 and 250 mL, P = 0.66), hospital stay (3.0 and 3.3 nights, P = 1.00), complications (3.5% and 4.6%, P = 0.77), positive margins (15.4% and 20.6%, P = 0.26) and biochemical recurrence (3.8% and 3.7%, P = 1.00) at a mean follow-up of 9.7 and 12.0 months, respectively. The operation was significantly longer for obese patients, by a mean of 15 min; all other variables were comparable in the two groups. The results from this study suggest that obese patients can expect a similar outcome to their non-obese counterparts after LRP, when operated on by an experienced surgeon.