The Impact of Obesity on the Use of a Totally Laparoscopic Distal Gastrectomy in Patients with Gastric Cancer

Abstract

PurposeSince a patient's obesity can affect the mortality and morbidity of the surgery, less drastic surgeries may have a major benefit for obese individuals. This study evaluated the feasibility of performing a totally laparoscopic distal gastrectomy, with intracorporeal anastomosis, in obese patients suffering from gastric cancer.Materials and MethodsThis was a retrospective analysis of the 138 patients, who underwent a totally laparoscopic distal gastrectomy from April 2005 to March 2009, at the National Kyushu Cancer Center. The body mass index of 20 patients was ≥25, and in 118 patients, it was <25 kg/m2.ResultsThe mean values of body mass index in the 2 groups were 27.3±2.2 and 21.4±2.3. Hypertension was significantly more frequent in the obese patients than in the non-obese patients. The intraoperative blood loss, duration of surgery, post-operative complication rate, post-operative hospital stay, and a number of retrieved lymph nodes were not significantly different between the two groups.ConclusionsIntracorporeal anastomosis seemed to have a benefit for obese individuals. Totally laparoscopic gastrectomy is, therefore, considered to be a safe and an effective modality for obese patients.

Effect of High Body Mass Index on Short- and Long-term Outcomes of Patients who Underwent Laparoscopic Gastrectomy for Advanced Gastric Cancer: A Case Control Study

“…We considered that this faster recovery should attribute to the better ability of nutrients absorption in high BMI patients. In terms of postoperative complications, the incidence rate was similar between the two BMI groups, which was consistent with previous studies [16,19,26]. In addition, there was no incidence of postoperative wound infections in both groups which we believe was attributed to the improvement of asepsis cognition and in laparoscopy in reducing the size of the abdominal incisions.…”

Totally Laparoscopic Distal Gastrectomy with D2 Lymphadenectomy and Billroth II Gastrojejunostomy for Gastric Cancer: Short- and Medium-term Results of 139 Consecutive Cases from a Single Institution

“…Furthermore, reconstruction through the small incision also has disadvantages, such as a potentially challenging specimen extrusion, contamination via the incision, and excessive pulling on the residual stomach 12. Hence, there is a need to develop a standardized methodology got reconstructing the digestive tract by the laparoscopic approach that is as simple and safe as possible.…”

Preoperative weight loss program involving a 20‐day very low‐calorie diet for obesity before laparoscopic gastrectomy for gastric cancer

“…In a study by Oki et al . , the mean operative time and number of retrieved lymph nodes during laparoscopic distal gastrectomy in Asian patients with a BMI ≥25 kg/m 2 were 321.9 min and 30.8, respectively. In a study by Sugimoto et al ., these figures were 212 min and 29 .…”