IMPACT OF OBESITY AND SURGICAL SKILLS IN LAPAROSCOPIC TOTALLY EXTRAPERITONEAL HERNIOPLASTY

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorKATO, Juliana Mika
dc.contributor.authorIUAMOTO, Leandro Ryuchi
dc.contributor.authorSUGUITA, Fábio Yuji
dc.contributor.authorESSU, Felipe Futema
dc.contributor.authorMEYER, Alberto
dc.contributor.authorANDRAUS, Wellington
dc.date.accessioned2017-10-31T14:47:32Z
dc.date.available2017-10-31T14:47:32Z
dc.date.issued2017
dc.description.abstractABSTRACT Background: Laparoscopic totally extraperitoneal (TEP) hernia repair is a technically demanding procedure. Recent studies have identified BMI as an independent factor for technical difficulty in the learning period. Aim: To analyze the effect of overweight and obesity on the technical difficulties of TEP. Method: Prospective study on patients who underwent a symptomatic inguinal hernia by means of the TEP technique. Were analyzed gender, BMI, previous surgery, hernia type, operative time and complications. Technical difficulty was defined by operative time, major complications and recurrence. Patients were classified into four groups: 1) underweight, if less than 18,5 kg/m²; 2) normal range if BMI between 18,5 and 24,9 kg/m²; 3) overweight if BMI between 25-29,9 kg/m²; and 4) obese if BMI≥30 kg/m². Results: The cohort had a total of 190 patients, 185 men and 5 women. BMI values ranged from 16-36 kg/m² (average 26 kg/m²). Average operating time was 55.4 min in bilateral hernia (15-150) and 37.8 min in unilateral (13-150). Time of surgery was statistically correlated with increased BMI in the first 93 patients (p=0.049). Conclusion: High BMI and prolonged operative time are undoubtedly correlated. However, this relationship may be statistically significant only in the learning period. Although several clinical features can influence surgical time, upon reaching an experienced level, surgeons appear to easily handle the challenges.
dc.description.abstractRESUMO Racional: A hernioplastia laparoscópica totalmente extraperitoneal (TEP) é procedimento tecnicamente exigente. Estudos recentes identificaram o IMC como um fator independente para a dificuldade técnica durante o período de aprendizagem. Objetivo: Analisar o efeito do sobrepeso e da obesidade sobre as dificuldades técnicas na TEP. Método: Estudo prospectivo em pacientes submetidos à hernioplastia inguinal sintomática por meio da TEP. Foram analisados gênero, IMC, operação prévia, tipo de hérnia, tempo operatório e presença de complicações. A dificuldade técnica foi definida pelo tempo operatório, complicações maiores e recorrência. Os pacientes foram classificados em quatro grupos: 1) baixo peso, se menor que 18,5 kg/m²; 2) peso normal se IMC entre 18,5 e 24,9 kg/m²; 3) sobrepeso se IMC entre 25 e 29,9 kg/m²; e 4) obesos se IMC≥30 kg/m². Resultados: A coorte incluiu 190 pacientes, 185 homens e cinco mulheres. Os valores de IMC variaram de 16-36 kg/m² (média de 26 kg/m²). O tempo médio de operação foi de 55,4 min nas hérnias bilaterais (15-150) e 37,8 min nas unilaterais (13-150). O tempo cirúrgico foi estatisticamente correlacionado com o aumento do IMC nos primeiros 93 pacientes (p=0,049). Conclusão: IMC elevado e tempo operatório prolongado estão indubitavelmente correlacionados. No entanto, esta relação pode ser estatisticamente significativa apenas no período de aprendizagem. Embora várias características clínicas possam influenciar o tempo cirúrgico, ao chegar a um nível experiente, os cirurgiões parecem lidar facilmente com os desafios.
dc.description.indexMEDLINE
dc.identifier.citationABCD-ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA-BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY, v.30, n.3, p.169-172, 2017
dc.identifier.doi10.1590/0102-6720201700030002
dc.identifier.eissn2317-6326
dc.identifier.issn0102-6720
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/22278
dc.language.isoeng
dc.publisherColégio Brasileiro de Cirurgia Digestiva
dc.relation.ispartofABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)
dc.rightsopenAccess
dc.rights.holderCopyright Colégio Brasileiro de Cirurgia Digestiva
dc.subjectHernia
dc.subjectBody mass index
dc.subjectHerniorraphy
dc.subjectLaparoscopic surgery
dc.subjectHérnia
dc.subjectÍndice de massa corpórea
dc.subjectHerniorrafia
dc.subjectCirurgia laparoscópica
dc.subject.otherBODY-MASS INDEX
dc.subject.otherINGUINAL-HERNIA REPAIR
dc.subject.otherLEARNING-CURVE
dc.subject.otherGROIN HERNIA
dc.subject.otherCOMPLICATIONS
dc.subject.otherSURGERY
dc.subject.otherTRIAL
dc.subject.otherTAPP
dc.subject.otherMESH
dc.titleIMPACT OF OBESITY AND SURGICAL SKILLS IN LAPAROSCOPIC TOTALLY EXTRAPERITONEAL HERNIOPLASTY
dc.title.alternativeIMPACTO DA OBESIDADE E HABILIDADES CIRÚRGICAS NA HERNIOPLASTIA LAPAROSCÓPICA TOTALMENTE EXTRAPERITONEAL
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.contributor.author-fmusphcJULIANA MIKA KATO
hcfmusp.contributor.author-fmusphcLEANDRO RYUCHI IUAMOTO
hcfmusp.contributor.author-fmusphcFABIO YUJI SUGUITA
hcfmusp.contributor.author-fmusphcFELIPE FUTEMA ESSU
hcfmusp.contributor.author-fmusphcALBERTO LUIZ MONTEIRO MEYER
hcfmusp.contributor.author-fmusphcWELLINGTON ANDRAUS
hcfmusp.description.beginpage169
hcfmusp.description.endpage172
hcfmusp.description.issue3
hcfmusp.description.volume30
hcfmusp.origemWOS
hcfmusp.origem.pubmed29019555
hcfmusp.origem.scieloSCIELO:S0102-67202017000300169
hcfmusp.origem.wosWOS:000416623100002
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