Effect of obesity on laparoscopy-assisted distal gastrectomy compared with open distal gastrectomy for gastric cancer.
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.
Makino
Hirochika
H
Department of Surgery, Yokohama City University, Gastroenterological Center, Minami-ku, Yokohama, Japan. hirochikm@hotmail.com
Kunisaki
Chikara
C
Izumisawa
Yusuke
Y
Tokuhisa
Motohiko
M
Oshima
Takashi
T
Nagano
Yasuhiko
Y
Fujii
Shoichi
S
Kimura
Jun
J
Takagawa
Ryo
R
Kosaka
Takashi
T
Ono
Hidetaka A
HA
Akiyama
Hirotoshi
H
Endo
Itaru
I
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