Abdominal shape of gastric cancer patients influences short-term surgical outcomes.
BACKGROUND
There is a prevailing belief that both obesity and abdominal shape influence abdominal accessibility, and thus affect short-term surgical outcomes of gastric cancer surgery.


METHODS
We measured the thickness of subcutaneous fat (SCF), abdominal anterior-posterior diameter (APD), transverse diameter (TD), and intra-abdominal fat volume (IFV) at the umbilicus level by using the abdominal CT scans of 291 gastric cancer patients who had undergone subtotal gastrectomy and D2 lymph node dissection. Clinicopathological factors including body mass index (BMI), APD, TD, IFV, and SCF and surgical outcomes, i.e., dissected lymph node number, morbidity, and mortality were analyzed.


RESULTS
SCF thickness, APD, TD, IFV, and BMI mean values were 20.0 mm (range 2.0-64.0), 188.4 mm (range 128.0-332.0), 301.4 mm (range 160.0-651.0), 198.3 mm(2) (range 123.4-312.1), and 23.9 kg/m(2) (range 16.6-34.6), respectively. In male patients, APD was found to correlate with the number of retrieved lymph nodes (P = 0.045). Whereas in female patients, this was not the case (P = 0.093). Twenty-one patients experienced postoperative complications but no postoperative mortality occurred. Female patients who experienced postoperative complications had higher APD (32.9 +/- 10.0 mm versus 26.1 +/- 7.9 mm, P = 0.044) and BMI (27.3 +/- 4.1 kg/m(2) versus 24.3 +/- 3.5 kg/m(2), P = 0.049) values than those who did not.


CONCLUSIONS
We conclude that obesity and abdominal shape of gastric cancer patients both influence the short-term surgical outcomes of subtotal gastrectomy with D2 lymph node dissection.
Lee
Jun Ho
JH
Research Institute and Hospital, National Cancer Center, 809 Madu1-dong, Ilsandong-gu, Goyang-si, Gyeonggi-do 411-769, Korea.
Paik
Yong Hae
YH
Lee
Jong Seok
JS
Ryu
Keun Won
KW
Kim
Chan Gyoo
CG
Park
Sook Ryeon
SR
Kim
Young Woo
YW
Kook
Myeong Cherl
MC
Nam
Byung-Ho
BH
Bae
Jae-Moon
JM
D000005:Abdomen / Q000473:pathology*; D000230:Adenocarcinoma / Q000601:surgery*; D000273:Adipose Tissue / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D049628:Body Size; D005260:Female; D005743:Gastrectomy; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011183:Postoperative Complications; D013274:Stomach Neoplasms / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome