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Feasibility of totally laparoscopic total gastrectomy in obese patients with gastric cancer

  • Original Article
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Abstract

Purpose

This study aimed to evaluate the short- and long-term outcomes in obese patients with gastric cancer undergoing totally laparoscopic total gastrectomy (TLTG) to clarify its feasibility in this population.

Methods

We examined 136 consecutive patients who underwent TLTG for gastric cancer (GC) between 2013 and 2018. A total of 45 patients with a body mass index (BMI) ≥ 25 kg/m2 were defined as the obese group (obese and overweight patients by the WHO classification), and 91 patients with a BMI < 25 kg/m2 were defined as the non-obese group. Short- and long-term outcomes were compared, and the correlation between obesity and postoperative complications was examined in patients who underwent TLTG.

Results

Although the operation time (min) was significantly longer in the obese group than in the non-obese group (329 vs 307, p = 0.002), there were no significant differences in the total volume of blood loss (mL) (118 vs 60, p = 0.059) or the rate of conversion to laparotomy between the two groups (2 vs 2, p = 0.466). Moreover, there was no significant difference in the incidence of postoperative complications between the two groups (16% vs 19%, p = 0.653). In the multivariate analysis, obesity was not identified as a risk factor for postoperative complications among patients who underwent TLTG. The rate of overall survival was not significantly different between the groups (p = 0.512).

Conclusion

TLTG is feasible for obese Japanese patients with GC. To validate the results of the present study, it is necessary to conduct a prospective study of a large population of patients with GC.

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Data availability

All data generated or analyzed during this study are included in this published article (and its supplementary information files).

Code availability

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Authors and Affiliations

  1. Department of Surgery, Gastroenterological Center, Yokohama City University, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan

    Hideaki Suematsu, Chikara Kunisaki, Hiroshi Miyamato, Kei Sato, Sho Sato & Yusaku Tanaka

  2. Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan

    Hideaki Suematsu

  3. Department of Surgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan

    Norio Yukawa, Yasushi Rino & Munetaka Masuda

  4. Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan

    Takashi Kosaka & Itaru Endo

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  1. Hideaki Suematsu
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Contributions

Study conception and design: All authors contributed to the conception and design of this study. Acquisition: Data collection was performed by H.S., C.K., H.M., K.S., S.S., Y.T., and T.K. Analysis and interpretation of data: The data was analyzed by H.S., C.K., H.M., K.S., S.S., Y.T., AND T.K. and interpreted by H.S., C.K., N.Y., Y.R., I.E., and M.M. Drafting of manuscript: H.S. and C.K. were responsible for manuscript preparation. Critical revision of manuscript: This paper has been revised and approved by all authors.

Corresponding author

Correspondence to Chikara Kunisaki.

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Ethics approval

This study was conducted in compliance with the principles of the Declaration of Helsinki. The study protocol was approved by the Yokohama City University Institutional Review Board (B200800017).

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Informed consent was obtained from all the patients.

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The participant has consented to the submission of the case report to the journal.

Conflict of interest

The authors declare no competing interests.

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Suematsu, H., Kunisaki, C., Miyamato, H. et al. Feasibility of totally laparoscopic total gastrectomy in obese patients with gastric cancer. Langenbecks Arch Surg 407, 999–1008 (2022). https://doi.org/10.1007/s00423-021-02369-5

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