Table 4.
Summary of past studies on the effects of obesity on outcomes of liver surgery
| Year | Author | Country | n | BMI stratification | Operation | Disease | Outcome |
|---|---|---|---|---|---|---|---|
| 2016 | Yokoo et al57 | Japan | 14 970 |
<30, 30< or <35, 35< |
Hx | Various | BMI > 30 was a risk factor for blood transfusion >5 units and renal failure, while BMI > 35 was a risk factor for unplanned intubation and cardiac events, according to a risk model for morbidities. |
| 2015 | Langella et al58 | Italy | 1021 | <30, 30< | Hepatectomy | Colorectal metastasis | Transection time and blood loss were greater in BMI > 30 subjects. There was no difference in postoperative mortality between the two groups. Overall morbidity was greater in BMI > 30 subjects, mainly as a result of pulmonary complications. On multivariate analysis, obesity independently predicted overall morbidity. |
| 2010 | Mathur et al59 | USA | 3960 | 18.5<, 18.5‐25, 25‐30, 30< | Hepatectomy | Various | Compared to normal‐weight patients, obese patients had significantly higher odds of having a complication. Obesity was not a significant predictor of mortality. |
| 2015 | Nomi et al61 | France | 228 | <25, 25‐30, 30< | Laparoscopic hepatectomy | Various | There were no significant differences in rates of postoperative mortality and overall complications. |
| 2014 | Wang et al63 | China | 1543 | <18.5, 18.5‐24, 24‐28, 28< | Hepatectomy | HBV‐related HCC | Mortality and total complications differed minimally among the four groups except for underweight patients having fewer total complications. Postoperative wound complications were more common in overweight and obese patients. |
| 2014 | Kenjo et al64 | Japan | 7732 | <30, 30< | Hx | Various | There were no differences in either the 30‐day mortality rate or the 90‐day in‐hospital mortality rate between obese and non‐obese patients. |
| 2015 | Saab et al65 | USA | 74 487 | Various | Liver transplantation | Various | Obesity did not adversely impact patient survival. |
| 2015 | Conzen et al67 | USA | 785 | <18, 18‐25, 25‐30, 30‐35, 35‐40, 40< | Liver transplantation | Various | Cox regression analysis confirmed BMI > 40 to be an independent predictor of poor survival. |
BMI, body mass index; HBV, hepatitis B virus; HCC, hepatocellular carcinoma; Hx, hepatectomy of more than one segment other than the lateral segment.