, Volume 41, Issue 7, pp 928-934
Date: 12 Jul 2011

Influence of excess body weight on the surgical outcomes of total gastrectomy

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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.


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/m2 or greater were defined as overweight (overweight group) and those with a BMI less than 25.0 kg/m2 as not overweight (non-overweight group).


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.


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.