Surgical Endoscopy

, Volume 27, Issue 11, pp 4291–4296 | Cite as

Short-term outcome of total laparoscopic distal gastrectomy for overweight and obese patients with gastric cancer

  • Motokazu Sugimoto
  • Takahiro Kinoshita
  • Hidehito Shibasaki
  • Yuichiro Kato
  • Naoto Gotohda
  • Shinichiro Takahashi
  • Masaru Konishi
Article
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Accepted:

Abstract

Background

Laparoscopic distal gastrectomy for gastric cancer has been firmly established in recent decades but still is a difficult procedure, especially for obese patients, as with open surgery. This study aimed to evaluate the perioperative outcome of total laparoscopic distal gastrectomy (TLDG) for early gastric cancer patients with a body mass index (BMI) exceeding 25 kg/m2 and to consider countermeasures to this.

Methods

Perioperative outcomes were compared between 42 patients with a BMI exceeding 25 kg/m2 [overweight or obese group (OWG)] and 174 patients with a BMI lower than 25 kg/m2 [normal or underweight group (NWG)] who underwent TLDG between September 2010 and December 2012.

Results

The BMI was 26.0 ± 1.4 kg/m2 in the OWG group and 22.0 ± 2.1 kg/m2 in the NWG group (P < 0.001). The groups did not differ in terms of age, sex, American Society of Anesthesiologists score, presence of diabetes, number of retrieved lymph nodes, number of metastatic lymph nodes, or metastatic lymph node ratio. The two groups did not differ significantly with respect to the extent of lymph node dissection [OWG: D1 (11.9 %), D1+ (66.7 %), D2 (21.4 %) vs NWG: D1 (5.2 %), D1+ (51.7 %), D2 (43.1 %); P = 0.020] or tumor size (OWG: 25.5 ± 20.2 mm vs NWG: 33.0 ± 17.2 mm; P = 0.037). Differences in operation time (OWG: 212 ± 31 min vs NWG: 200 ± 35 min; P = 0.005) and estimated blood loss (OWG: 15 ± 22 ml vs NWG: 10 ± 34 ml; P = 0.013) seemed to have a minimal impact clinically. Postoperative complications including infectious complications and recovery after surgery did not differ between the two groups.

Conclusions

For overweight and obese patients, TLDG was managed safely. The procedure was considered to be difficult but sufficiently feasible.

Keywords

Total laparoscopic distal gastrectomy Gastric cancer Overweight Body mass index Postoperative complication Postoperative recovery 
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Notes

Disclosures

Motokazu Sugimoto, Takahiro Kinoshita, Hidehito Shibasaki, Yuichiro Kato, Naoto Gotohda, Shinichiro Takahashi, and Masaru Konishi have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Motokazu Sugimoto
    • 1
  • Takahiro Kinoshita
    • 1
  • Hidehito Shibasaki
    • 1
  • Yuichiro Kato
    • 1
  • Naoto Gotohda
    • 1
  • Shinichiro Takahashi
    • 1
  • Masaru Konishi
    • 1
  1. 1.Department of Digestive Surgical OncologyNational Cancer Center Hospital EastKashiwaJapan

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