World Journal of Surgery

, Volume 35, Issue 6, pp 1327–1332 | Cite as

A Totally Laparoscopic Distal Gastrectomy Can Be an Effective Way of Performing Laparoscopic Gastrectomy in Obese Patients (Body Mass Index ≥ 30)

  • Min Gyu Kim
  • Kap Choong Kim
  • Beom Su Kim
  • Tae Hwan Kim
  • Hee Sung Kim
  • Jeong Hwan Yook
  • Byung Sik KimEmail author



In the surgical treatment of gastric cancer, obesity is known to be a predictive factor for poor early surgical outcomes. To evaluate the more effective modality of laparoscopic gastrectomy in obese patients, we compared the early surgical outcomes of laparoscopy-assisted and totally laparoscopic gastrectomy.


We retrospectively analyzed early surgical outcomes in 1,480 consecutive patients who underwent distal gastrectomy for gastric cancer between April 2004 and July 2010. To compare surgical outcomes of laparoscopy-assisted distal gastrectomy (LADG) with those of totally laparoscopic distal gastrectomy (TLDG) in 76 obese patients (LADG, n = 39; TLDG, n = 37), the patients were classified as either obese or nonobese. The obesity was defined using the WHO classification BMI cutoff of 30 kg/m2.


In the analysis of surgical outcomes of the LADG group, there were significant differences between the obese and nonobese groups with respect to operative time (P = 0.004, obese, 171.8 min; nonobese, 141.0 min), time to first flatus (P = 0.027, obese, 3.3 days; nonobese, 3.1 days), commencement of soft diet (P = 0.040, obese, 4.6 days; nonobese, 4.0 days), postoperative complication rate (P = 0.045, obese, 15.4%; nonobese, 6.5%), and postoperative hospital stay (P = 0.014, obese, 8.9 days; nonobese, 7.2 days). In TLDG group, on the other hand, there were no significant differences in surgical outcomes between the groups.


Based on these findings, early surgical outcomes of LADG were strongly influenced by the obesity. TLDG without minilaparotomy, however, was unaffected by the obesity. These findings strongly suggest that TLDG could be a safe procedure to avoid the impact of obesity.


Obese Patient Distal Gastrectomy Nonobese Patient Laparoscopic Gastrectomy Soft Diet 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflict of interest

Min Gyu Kim, Beom Su Kim, Tae Hwan Kim, Hee Sung Kim, Kap Choong Kim, Jeong Hwan Yook, and Byung Sik Kim, have no conflicts of interest or financial ties to disclose.


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Copyright information

© Société Internationale de Chirurgie 2011

Authors and Affiliations

  • Min Gyu Kim
    • 1
  • Kap Choong Kim
    • 1
  • Beom Su Kim
    • 1
  • Tae Hwan Kim
    • 1
  • Hee Sung Kim
    • 1
  • Jeong Hwan Yook
    • 1
  • Byung Sik Kim
    • 1
    Email author
  1. 1.Division of Gastric Surgery, Department of Surgery, Asan Medical CenterUlsan UniversitySeoulRepublic of Korea

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