Increased Fat Content and Body Shape Have Little Effect on the Accuracy of Lymph Node Retrieval and Blood Loss in Laparoscopic Distal Gastrectomy for Gastric Cancer

Abstract

The present study demonstrated that increased fat content and large body shape have little effect on the number of lymph nodes retrieved and blood loss in LADG. However, for patients undergoing conventional open distal gastrectomy, increased fat content and large body shape do impact on the amount of blood lost and the number of lymph nodes retrieved.

The impact of abdominal shape index of patients on laparoscopy-assisted distal gastrectomy for early gastric cancer

“…Their study of 152 patients clearly showed that a high BMI and high VFA can predict technical difficulties during LADG, as well as postoperative complications [14]. On the other hand, some reports have shown no significant differences between obese and nonobese patients in terms of postoperative complication rates [6,15,17,32]. Hiki et al showed that a high VFA did not affect the incidence of postoperative complications [17].…”

“…On the other hand, some reports have shown no significant differences between obese and nonobese patients in terms of postoperative complication rates [6,15,17,32]. Hiki et al showed that a high VFA did not affect the incidence of postoperative complications [17]. Noshiro et al also revealed that LADG can be safely performed in obese patients with a high BMI [6].…”

“…Some reports of LADG have suggested that obesity is a key risk factor for predicting postoperative complications [14,15]. On the other hand, several reports have shown the feasibility and safety of LADG for gastric cancer in obese patients [6,10,16,17]. However, there have been very few reports on the effect of obesity on the technical feasibility and postoperative outcomes of LADG in terms of a detailed abdominal shape of patients indicated by the VFA, subcutaneous fat, or body size.…”

Implications of overweight in gastric cancer: A multicenter study in a Western patient population

“…Most previous retrospective studies from Asian populations suggest that BMI influences the occurrence of surgical complications in gastric cancer surgery indirectly by increasing operation time [8][9][10]12 and blood loss [8][9][10]23 , but also directly increasing rates of pancreatic fistula 6-8 and abdominal abscess. 8,24 Moreover, these observations are supported by the results of randomized clinical trials confirming the detrimental effects of overweight.…”

“…Such assumptions are based on several observations concerning the different extent of lymphadenectomy. 5,9,21,23 However, previous reports from Western population-based databases and randomized clinical trials provided no data on the influence of BMI on the likelihood of undergoing adequate lymph node assessment. 15,[26][27][28][29] In the present study, BMI significantly affected the proportion of patients with 15 or less lymph nodes removed and after stratifying patients for the extent of lymphadenectomy, this effect was preserved for both M A N U S C R I P T…”