The safety of pelvic surgery in the morbidly obese with and without combined panniculectomy: a comparison of results.

Abstract

The purpose of our study was to evaluate the benefit of panniculectomy combined with pelvic surgery in the morbidly obese patient. Previous literature has found this combined procedure in this particular patient population to have increased morbidity and that it was not beneficial. A chart review was performed an all patients who underwent pelvic surgery with or without a panniculectomy between June 2004 and June 2005. Only morbidly obese patients (body mass index of >40 kg/m2) were included in the study. Factors evaluated were operative times, intraoperative blood loss, weight of pannus resection specimen, length of hospital stay, wound infection rate, and other complications. All data were analyzed using Levene test for equality of variances and the t test for the equality of means. Thirty-six patients had combined panniculectomy and abdominal hysterectomy, 14 had an abdominal hysterectomy without a panniculectomy. The mean operative times for the combined procedure was 3.4 hours versus 2.6 hours without panniculectomy. The mean estimated blood loss was 526 mL for the combined procedure (CP) and 536 mL for hysterectomy alone (HA). There were 2 wound infections in the CP group (5.6%) versus 3 in the HA group (21.4%). There was one wound dehiscence in the CP group (2.8%) and one in the HA group (7.1%). There was one inadvertent enterotomy in the HA group (7.1%) and none in the CP group. There were no statistical differences noted for any variable including patient body mass index, mean operative time, estimated blood loss, or rate of complications. Our findings, in contrast to previous findings, reveal that panniculectomy combined with pelvic surgery in the morbidly obese is a safe procedure that can decrease the incidence of intraoperative complications and postoperative wound complications without significantly increasing operative time or blood loss.