Evidence map›Paper›PMID 29770882›Full record

ArticleSurgical endoscopy2018

Does obesity influence the results in Transvaginal Hybrid-NOTES cholecystectomy?

Dirk R Bulian, Jurgen Knuth, Panagiotis Thomaidis, Anna Rieger, Claudia Simone Seefeldt, Jonas Lange, Jurgen Meyer, Michael A Stroehlein, Markus M Heiss

Abstract read
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Article in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Dirk R BulianDepartment of Abdominal, Vascular and Transplant Surgery, Cologne-Merheim Medical Center (CMMC), Witten/Herdecke University, Ostmerheimer Strasse 200, 51109, Cologne, Germany. dirk.bulian@uni-wh.de.
Jurgen KnuthDepartment of Abdominal, Vascular and Transplant Surgery, Cologne-Merheim Medical Center (CMMC), Witten/Herdecke University, Ostmerheimer Strasse 200, 51109, Cologne, Germany.
Panagiotis ThomaidisDepartment of Abdominal, Vascular and Transplant Surgery, Cologne-Merheim Medical Center (CMMC), Witten/Herdecke University, Ostmerheimer Strasse 200, 51109, Cologne, Germany.
Anna RiegerDepartment of Abdominal, Vascular and Transplant Surgery, Cologne-Merheim Medical Center (CMMC), Witten/Herdecke University, Ostmerheimer Strasse 200, 51109, Cologne, Germany.
Claudia Simone SeefeldtDepartment of Abdominal, Vascular and Transplant Surgery, Cologne-Merheim Medical Center (CMMC), Witten/Herdecke University, Ostmerheimer Strasse 200, 51109, Cologne, Germany.
Jonas LangeDepartment of Abdominal, Vascular and Transplant Surgery, Cologne-Merheim Medical Center (CMMC), Witten/Herdecke University, Ostmerheimer Strasse 200, 51109, Cologne, Germany.
Jurgen MeyerDepartment of Abdominal, Vascular and Transplant Surgery, Cologne-Merheim Medical Center (CMMC), Witten/Herdecke University, Ostmerheimer Strasse 200, 51109, Cologne, Germany.
Michael A StroehleinDepartment of Abdominal, Vascular and Transplant Surgery, Cologne-Merheim Medical Center (CMMC), Witten/Herdecke University, Ostmerheimer Strasse 200, 51109, Cologne, Germany.
Markus M HeissDepartment of Abdominal, Vascular and Transplant Surgery, Cologne-Merheim Medical Center (CMMC), Witten/Herdecke University, Ostmerheimer Strasse 200, 51109, Cologne, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMorbidly obese patients are usually excluded from studies that compare Transvaginal Hybrid-NOTES Cholecystectomy (TVC) with traditional laparoscopic cholecystectomy. Therefore, these study results cannot necessarily be transferred to this group of patients. In this study, we have analyzed and compared the outcomes of the procedure with obese and non-obese patients.

methodsData from a prospectively maintained database were retrospectively analyzed. All the TVCs performed in our clinic since 2008 were divided into groups according to their body mass index (BMI). Within these groups, we evaluated the following outcome parameters: age, ASA classification, procedural time, number of percutaneous trocars, intra- and postoperative complications, and postoperative hospital stay. Additionally, the posthospital surgical and gynecological follow-up was evaluated for additional complications and patients with class III obesity were contacted to determine further parameters.

resultsSix underweight, 76 normal weight, 72 overweight, 48 class I obesity, 15 class II obesity, and 20 class III obesity patients were analyzed. ASA classification (P < 0.001), procedural time (P < 0.001), and number of percutaneous trocars (P < 0.001) significantly increased with the BMI. By contrast, intra- and postoperative complications (P = 0.134 and P = 0.571), as well as postoperative hospital stay (P = 0.076) did not depend on the BMI. Neither did the classification according to Clavien/Dindo show a significant relation (P = 0.640). Lethality was zero. All posthospital gynecological follow-ups were inconspicuous. Telephone follow-up of class III obesity patients reached a rate of 85% after median 3.4 years. There were no additional complications or problems during sexual intercourse. The satisfaction with the cosmetic and the overall result was very high.

conclusionsAlthough the results of existing studies including normal-weight or merely moderately obese patients can hardly be applied to morbidly obese patients, especially regarding procedural time and the number of percutaneous trocars, obesity should not be an exclusion criterion for TVC, regardless of its magnitude.

Indexed as

Cholecystectomy, LaparoscopicGallbladder DiseasesNatural Orifice Endoscopic SurgeryObesity, MorbidPostoperative ComplicationsVaginaBody Mass IndexFemaleGermanyHumansLength of StayMiddle AgedOutcome and Process Assessment, Health CareRetrospective StudiesBody mass indexComplicationsNOTESObesityTransvaginal cholecystectomy

Identifiers

PMID29770882

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.