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A totally laparoscopic distal gastrectomy can be an effective way of performing laparoscopic gastrectomy in obese patients (body mass index≥30).
- Source :
-
World journal of surgery [World J Surg] 2011 Jun; Vol. 35 (6), pp. 1327-32. - Publication Year :
- 2011
-
Abstract
- Background: 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.<br />Methods: 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.<br />Results: 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.<br />Conclusion: 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.
- Subjects :
- Aged
Body Mass Index
Cohort Studies
Female
Follow-Up Studies
Gastrectomy adverse effects
Gastroscopy methods
Humans
Male
Middle Aged
Minimally Invasive Surgical Procedures adverse effects
Minimally Invasive Surgical Procedures methods
Neoplasm Invasiveness pathology
Neoplasm Staging
Obesity complications
Obesity diagnosis
Obesity surgery
Pneumoperitoneum, Artificial methods
Postoperative Complications epidemiology
Postoperative Complications physiopathology
Reference Values
Republic of Korea
Retrospective Studies
Risk Assessment
Stomach Neoplasms mortality
Survival Analysis
Time Factors
Treatment Outcome
Gastrectomy methods
Laparoscopy methods
Stomach Neoplasms pathology
Stomach Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1432-2323
- Volume :
- 35
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- World journal of surgery
- Publication Type :
- Academic Journal
- Accession number :
- 21424875
- Full Text :
- https://doi.org/10.1007/s00268-011-1034-6