title: Body composition changes after totally laparoscopic distal gastrectomy with delta-shaped anastomosis: a comparison with conventional Billroth I anastomosis.
abstract: The purpose of this study was to compare body composition changes of patients undergoing totally laparoscopic distal gastrectomy (TLDG) with delta-shaped anastomosis (DSA) versus conventional laparoscopic distal gastrectomy (CLDG).
  
  
  
  Data from gastric cancer patients who underwent laparoscopic distal gastrectomy for histologically proven gastric cancer in KNUMC from January 2013 to May 2014 were collected and reviewed. We examined 85 consecutive patients undergoing TLDG or CLDG: 41 patients underwent TLDG and 44 patients underwent CLDG. Body composition was assessed by segmental multifrequency bioelectrical impedance analysis. We compared the changes in nutritional parameters and body composition from preoperative status between the two groups at postoperative 6 and 12 months.
  
  
  
  All of the postoperative changes in the body composition and nutritional indices were similar between the two groups with the exception of visceral fat areas (VFAs) and albumin levels. VFAs increased at 6 months postoperatively in the TLDG group and a significant difference was shown at 12 months postoperatively between the TLDG and CLDG groups (86.7 ± 22.8 and 74.7 ± 21.9 cm(2), respectively, P < 0.05). Postoperative albumin levels were higher in the TLDG group with statistical significance at 6 and 12 months after surgery (6 months, P = 0.028; 12 months, P = 0.012).
  
  
  
  The influence of TLDG with DSA on nutrition and body composition seemed comparable to those of CLDG. Six months postoperatively, VFAs and albumin levels were recovered in the TLDG group but not in the CLDG group. Thus, TLDG seems to be a novel surgical method.
authors.affiliation: Gastric Cancer Center, Kyungpook National University Medical Center, 474 Hakjeongdong, Buk-gu, Daegu, 702-210, Republic of Korea. parkeagle82@naver.com.
authors.forename: Ki Bum
authors.initials: KB
authors.lastname: Park
authors.affiliation: Gastric Cancer Center, Kyungpook National University Medical Center, 474 Hakjeongdong, Buk-gu, Daegu, 702-210, Republic of Korea.
authors.forename: Oh Kyoung
authors.initials: OK
authors.lastname: Kwon
authors.affiliation: Gastric Cancer Center, Kyungpook National University Medical Center, 474 Hakjeongdong, Buk-gu, Daegu, 702-210, Republic of Korea.
authors.forename: Wansik
authors.initials: W
authors.lastname: Yu
authors.affiliation: Department of Molecular Medicine, College of Medicine, Keimyung University, Daegu, Republic of Korea.
authors.forename: Byeong-Churl
authors.initials: BC
authors.lastname: Jang
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods*; D001823:Body Composition; D017097:Electric Impedance; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005763:Gastroenterostomy; D006801:Humans; D050152:Intra-Abdominal Fat / Q000033:anatomy & histology; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012709:Serum Albumin / Q000032:analysis; D013274:Stomach Neoplasms / Q000601:surgery*
chemical_list: D012709:Serum Albumin
keywords: Body composition; Delta-shaped anastomosis; Gastric cancer; Laparoscopic surgery
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