title: Effect of obesity on laparoscopy-assisted distal gastrectomy compared with open distal gastrectomy for gastric cancer.
abstract: OBJECTIVE
  This study compared surgical outcomes between patients undergoing laparoscopy-assisted distal gastrectomy (LADG) and those undergoing open distal gastrectomy (ODG) from the viewpoint of obesity.
  
  
  METHODS
  Between June 2002 and May 2008, 146 patients with preoperatively diagnosed early gastric cancer who underwent LADG (n = 90) or ODG (n = 56) were enrolled in this study and compared in terms of clinicopathological findings and operative outcome. The visceral fat area (VFA) and subcutaneous fat area (SFA) were assessed as identifiers of obesity using FatScan software. The relationship between obesity and operative outcomes after LADG and ODG was evaluated.
  
  
  RESULTS
  There were no significant correlations between intraoperative blood loss (IBL) and any obesity-related factors, or between operation time (OT) and any obesity-related factors in the LADG group. There was a significant correlation between IBL and BMI (r = 0.486, P = 0.0001), IBL and VFA (r = 0.456, P = 0.0003), IBL and SFA (r = 0.311, P = 0.0193), OT and BMI (r = 0.406, P = 0.0017), OT and VFA (r = 0.314, P = 0.0178), and between OT and SFA (r = 0.382, P = 0.0034) in the ODG group.
  
  
  CONCLUSIONS
  LADG may be a useful operative manipulation that is not influenced by obesity, whereas ODG may be influenced by obesity even after reaching the surgical plateau.
authors.affiliation: Department of Surgery, Yokohama City University, Gastroenterological Center, Minami-ku, Yokohama, Japan. hirochikm@hotmail.com
authors.forename: Hirochika
authors.initials: H
authors.lastname: Makino
authors.forename: Chikara
authors.initials: C
authors.lastname: Kunisaki
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Izumisawa
authors.forename: Motohiko
authors.initials: M
authors.lastname: Tokuhisa
authors.forename: Takashi
authors.initials: T
authors.lastname: Oshima
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Nagano
authors.forename: Shoichi
authors.initials: S
authors.lastname: Fujii
authors.forename: Jun
authors.initials: J
authors.lastname: Kimura
authors.forename: Ryo
authors.initials: R
authors.lastname: Takagawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Kosaka
authors.forename: Hidetaka A
authors.initials: HA
authors.lastname: Ono
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Akiyama
authors.forename: Itaru
authors.initials: I
authors.lastname: Endo
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery; D000368:Aged; D016063:Blood Loss, Surgical; D015992:Body Mass Index; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009765:Obesity / Q000150:complications*; D013274:Stomach Neoplasms / Q000601:surgery*; D050507:Subcutaneous Fat, Abdominal; D013997:Time Factors