title: Surgical effects of obesity on laparoscopy-assisted distal gastrectomy.
abstract: OBJECTIVE
  To compare the effects of obesity on laparoscopy-assisted distal gastrectomy (LADG) and open distal gastrectomy (ODG).
  
  
  METHODS
  A retrospective study was conducted on 249 patients, who underwent LADG and 224 patients who underwent ODG.
  
  
  RESULTS
  The regression coefficient of the primary regression equation between operative time and body mass index (BMI) for LADG was greater than ODG; and between blood loss and BMI for LADG was almost the same as ODG. In overweight patients (BMI ≥25), no significant difference was seen between LADG and ODG regarding postoperative complications, and the benefits of the less-invasive nature of LADG were also seen in some parameters.
  
  
  CONCLUSIONS
  Obesity-associated difficulties are more while performing LADG than during ODG; however, the influence of obesity on LADG decreases with surgical experience. Moreover, even in overweight patients, the benefits of the less-invasive nature of LADG still remain, but the degree of the benefits is smaller than that in nonobese patients.
authors.affiliation: Department of Surgery, JA Sapporo Kosei Hospital, Sapporo, Japan. h.kawamura@ja-hokkaidoukouseiren.or.jp
authors.forename: Hideki
authors.initials: H
authors.lastname: Kawamura
authors.forename: Toshiro
authors.initials: T
authors.lastname: Tanioka
authors.forename: Tohru
authors.initials: T
authors.lastname: Funakoshi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009765:Obesity / Q000150:complications*; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome