title: Effect of visceral fat area on outcomes of laparoscopyassisted distal gastrectomy for gastric cancer: subgroup analysis by gender and parameters of obesity.
abstract: OBJECTIVE
  The aim of this study was to investigate the impact of the visceral fat area (VFA) of patients with gastric cancer undergoing laparoscopic surgery on operative outcomes such as number of retrieved lymph nodes (LNs) and operative time.
  
  
  METHODS
  We retrospectively reviewed the medical records and the CT scans of 597 patients with gastric cancer who underwent laparoscopy assisted distal gastrectomy (LADG) with partial omentectomy and LN dissection (>D1 plus beta). Patients were stratified by gender, VFA, and body mass index (BMI), and the clinicopathologic characteristics and operative outcomes were evaluated. Multiple linear regression analysis was used to assess the effects of VFA and BMI on the number of retrieved LNs and operative time in male and female patients.
  
  
  RESULTS
  The mean number of retrieved LNs was significantly decreased for both male and female patients with high VFA. The operative time was significantly longer for both male and female patients with high VFA. The number of retrieved LNs had a statistically significant negative correlation with VFA in both men and women, but not with BMI. The operative time had a statistically significant positive correlation with VFA in men, whereas the operative time had a statistically significant positive correlation with BMI in women.
  
  
  CONCLUSIONS
  The preoperative VFA of male patients with gastric cancer who undergo LADG may affect the number of retrieved LNs and operative time. VFA was more useful than BMI for predicting outcomes of LADG.
authors.affiliation: Dong-A University College of Medicine, Busan, Korea.
authors.forename: Ji-Eon
authors.initials: JE
authors.lastname: Go
authors.affiliation: Department of Surgery, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Min-Chan
authors.initials: MC
authors.lastname: Kim
authors.affiliation: Department of Surgery, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Ki-Han
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Department of Radiology, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Jong-Young
authors.initials: JY
authors.lastname: Oh
authors.affiliation: Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Yoo-Min
authors.initials: YM
authors.lastname: Kim
keywords: Body mass index; Laparoscopy; Stomach neoplasms; Visceral fat