title: Obesity and outcome of distal gastrectomy with D2 lymphadenectomy for carcinoma.
abstract: 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.
authors.affiliation: Department of Surgery II, Nagoya University School of Medicine Nagoya, Aichi 466-8550, Japan. ykodera@med.nagoya-u.ac.jp
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kodera
authors.forename: Seiji
authors.initials: S
authors.lastname: Ito
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Yamamura
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Mochizuki
authors.forename: Michitaka
authors.initials: M
authors.lastname: Fujiwara
authors.forename: Kenji
authors.initials: K
authors.lastname: Hibi
authors.forename: Katsuki
authors.initials: K
authors.lastname: Ito
authors.forename: Seiji
authors.initials: S
authors.lastname: Akiyama
authors.forename: Akimasa
authors.initials: A
authors.lastname: Nakao
mesh_terms: 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