title: Influence of excess body weight on the surgical outcomes of total gastrectomy.
abstract: OBJECTIVE
  We conducted this retrospective study to identify the influence of excess body weight on the surgical outcome of total gastrectomy (TG) and to evaluate recent advances in this operation.
  
  
  METHODS
  The subjects were 644 consecutive gastric cancer patients who underwent TG between 1992 and 2008. Patients with a body mass index (BMI) of 25.0 kg/m(2) or greater were defined as overweight (overweight group) and those with a BMI less than 25.0 kg/m(2) as not overweight (non-overweight group).
  
  
  RESULTS
  The operating times were longer (P = 0.005) and intraoperative blood loss was greater (P < 0.001) in the overweight group. The incidence of overall postoperative complications (P = 0.012) and of pancreatic fistula (P < 0.001) were significantly higher in the overweight group. In recent years, we achieved a reduction in operating time (P < 0.001), intraoperative blood loss (P = 0.033), and incidence of pancreatic fistula (P = 0.005), while maintaining curability, in the overweight group.
  
  
  CONCLUSIONS
  Although TG for gastric cancer is technically more difficult in overweight patients, they should not be denied this operation. Conversely, we should make a greater effort to improve the surgical outcomes of overweight patients.
authors: Department of Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
authors: Daisuke
authors: D
authors: Nobuoka
authors: Naoto
authors: N
authors: Gotohda
authors: Yuichiro
authors: Y
authors: Kato
authors: Shinichiro
authors: S
authors: Takahashi
authors: Masaru
authors: M
authors: Konishi
authors: Taira
authors: T
authors: Kinoshita
mesh_terms: D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology*; D016009:Chi-Square Distribution; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome