Obesity and outcome of distal gastrectomy with D2 lymphadenectomy for carcinoma.
OBJECTIVE
Obesity has correlated with surgical outcome in patients undergoing elective surgery for various cancers. This relationship has not been examined for gastric cancer surgery performed at a specialized high-volume center.


METHODS
Data from 562 consecutive patients treated with potentially curative distal gastrectomy between 1993 and 1999 were used. Patients were assigned to 2 groups according to a combination of Japanese and Western criteria for obesity (group A, body mass index < 25 for men and < 22 for women; or group B, body mass index > or = 27). Relationships between obesity and clinical variables were analyzed.


RESULTS
Two hundred and five patients (29.4%) were obese by Japanese cutoff values; only 50 (7.2%) were obese by Western standards. A significant difference in blood loss and operative time was noted between groups. Intra-abdominal infection was more frequent for group B, leading to significantly longer hospitalization. Lymph node yield was significantly smaller in group B, but no influence of obesity on long-term survival was observed.


CONCLUSIONS
Obesity can increase duration of surgery, volume of blood loss, and incidence of surgical complications, but does not affect long-term survival.
Kodera
Yasuhiro
Y
Department of Surgery II, Nagoya University School of Medicine Nagoya, Aichi 466-8550, Japan. ykodera@med.nagoya-u.ac.jp
Ito
Seiji
S
Yamamura
Yoshitaka
Y
Mochizuki
Yoshinari
Y
Fujiwara
Michitaka
M
Hibi
Kenji
K
Ito
Katsuki
K
Akiyama
Seiji
S
Nakao
Akimasa
A
D018784:Abdominal Abscess / Q000453:epidemiology / Q000209:etiology; D016063:Blood Loss, Surgical; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications* / Q000601:surgery*; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome