Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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The Impact of Obesity on the Use of a Totally Laparoscopic Distal Gastrectomy in Patients with Gastric Cancer

  • Oki, Eiji (Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University) ;
  • Sakaguchi, Yoshihisa (Department of Gastroenterological Surgery, National Kyushu Cancer Center) ;
  • Ohgaki, Kippei (Department of Gastroenterological Surgery, National Kyushu Cancer Center) ;
  • Saeki, Hiroshi (Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University) ;
  • Chinen, Yoshiki (Department of Gastroenterological Surgery, National Kyushu Cancer Center) ;
  • Minami, Kazuhito (Department of Gastroenterological Surgery, National Kyushu Cancer Center) ;
  • Sakamoto, Yasuo (Department of Gastroenterological Surgery, National Kyushu Cancer Center) ;
  • Toh, Yasushi (Department of Gastroenterological Surgery, National Kyushu Cancer Center) ;
  • Kusumoto, Testuya (Department of Gastroenterological Surgery, National Beppu Medical Center) ;
  • Okamura, Takeshi (Department of Gastroenterological Surgery, National Kyushu Cancer Center) ;
  • Maehara, Yoshihiko (Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University)
  • Received : 2012.03.02
  • Accepted : 2012.05.07
  • Published : 2012.06.30
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Abstract

Purpose: Since 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 Methods: This 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 ${\geq}25$, and in 118 patients, it was <25 kg/$m^2$. Results: The mean values of body mass index in the 2 groups were $27.3{\pm}2.2$ and $21.4{\pm}2.3$. 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. Conclusions: Intracorporeal 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.

Keywords

References

  1. Kitano S, Iso Y, Moriyama M, Sugimachi K. Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc 1994;4:146-148.
  2. Bittner R, Butters M, Ulrich M, Uppenbrink S, Beger HG. Total gastrectomy. Updated operative mortality and long-term survival with particular reference to patients older than 70 years of age. Ann Surg 1996;224:37-42. https://doi.org/10.1097/00000658-199607000-00006
  3. Eguchi T, Fujii M, Takayama T. Mortality for gastric cancer in elderly patients. J Surg Oncol 2003;84:132-136. https://doi.org/10.1002/jso.10303
  4. Mochiki E, Ohno T, Kamiyama Y, Aihara R, Nakabayashi T, Asao T, et al. Laparoscopy-assisted gastrectomy for early gastric cancer in young and elderly patients. World J Surg 2005;29:1585-1591. https://doi.org/10.1007/s00268-005-0208-5
  5. Wu CW, Hsieh MC, Lo SS, Wang LS, Hsu WH, Lui WY, et al. Morbidity and mortality after radical gastrectomy for patients with carcinoma of the stomach. J Am Coll Surg 1995;181:26-32.
  6. Yamada H, Kojima K, Inokuchi M, Kawano T, Sugihara K. Effect of obesity on technical feasibility and postoperative outcomes of laparoscopy-assisted distal gastrectomy--comparison with open distal gastrectomy. J Gastrointest Surg 2008;12:997-1004. https://doi.org/10.1007/s11605-007-0374-x
  7. Yasuda K, Inomata M, Shiraishi N, Izumi K, Ishikawa K, Kitano S. Laparoscopy-assisted distal gastrectomy for early gastric cancer in obese and nonobese patients. Surg Endosc 2004;18:1253-1256. https://doi.org/10.1007/s00464-003-9310-7
  8. Noshiro H, Shimizu S, Nagai E, Ohuchida K, Tanaka M. Laparoscopy-assisted distal gastrectomy for early gastric cancer: is it beneficial for patients of heavier weight? Ann Surg 2003;238:680-685. https://doi.org/10.1097/01.sla.0000094302.51616.2a
  9. Ikeda O, Sakaguchi Y, Aoki Y, Harimoto N, Taomoto J, Masuda T, et al. Advantages of totally laparoscopic distal gastrectomy over laparoscopically assisted distal gastrectomy for gastric cancer. Surg Endosc 2009;23:2374-2379. https://doi.org/10.1007/s00464-009-0360-3
  10. Japanese Gastric Cancer Association, eds. Japanese Classification of Gastric Carcinoma 13th edition (Japanese). Tokyo: Kanehara publishing, 1999.
  11. Sakaguchi Y, Ikeda O, Toh Y, Aoki Y, Harimoto N, Taomoto J, et al. New technique for the retraction of the liver in laparoscopic gastrectomy. Surg Endosc 2008;22:2532-2534. https://doi.org/10.1007/s00464-008-9801-7
  12. Kanaya S, Gomi T, Momoi H, Tamaki N, Isobe H, Katayama T, et al. Delta-shaped anastomosis in totally laparoscopic Billroth I gastrectomy: new technique of intraabdominal gastroduodenostomy. J Am Coll Surg 2002;195:284-287. https://doi.org/10.1016/S1072-7515(02)01239-5
  13. Takaori K, Nomura E, Mabuchi H, Lee SW, Agui T, Miyamoto Y, et al. A secure technique of intracorporeal Roux-Y reconstruction after laparoscopic distal gastrectomy. Am J Surg 2005;189:178-183. https://doi.org/10.1016/j.amjsurg.2004.09.008
  14. Kitano S, Shiraishi N, Fujii K, Yasuda K, Inomata M, Adachi Y. A randomized controlled trial comparing open vs laparoscopyassisted distal gastrectomy for the treatment of early gastric cancer: an interim report. Surgery 2002;131:S306-311. https://doi.org/10.1067/msy.2002.120115
  15. Kim KH, Kim MC, Jung GJ, Kim HH. The impact of obesity on LADG for early gastric cancer. Gastric Cancer 2006;9:303-307. https://doi.org/10.1007/s10120-006-0395-2
  16. Lee HJ, Kim HH, Kim MC, Ryu SY, Kim W, Song KY, et al; Korean Laparoscopic Gastrointestinal Surgery Study Group. The impact of a high body mass index on laparoscopy assisted gastrectomy for gastric cancer. Surg Endosc 2009;23:2473-2479. https://doi.org/10.1007/s00464-009-0419-1
  17. Guzman EA, Pigazzi A, Lee B, Soriano PA, Nelson RA, Benjamin Paz I, et al. Totally laparoscopic gastric resection with extended lymphadenectomy for gastric adenocarcinoma. Ann Surg Oncol 2009;16:2218-2223. https://doi.org/10.1245/s10434-009-0508-3
  18. Huscher CG, Mingoli A, Sgarzini G, Brachini G, Binda B, Di Paola M, et al. Totally laparoscopic total and subtotal gastrectomy with extended lymph node dissection for early and advanced gastric cancer: early and long-term results of a 100-patient series. Am J Surg 2007;194:839-844. https://doi.org/10.1016/j.amjsurg.2007.08.037
  19. Barber GR, Miransky J, Brown AE, Coit DG, Lewis FM, Thaler HT, et al. Direct observations of surgical wound infections at a comprehensive cancer center. Arch Surg 1995;130:1042-1047. https://doi.org/10.1001/archsurg.1995.01430100020005
  20. Tsukada K, Miyazaki T, Kato H, Masuda N, Fukuchi M, Fukai Y, et al. Body fat accumulation and postoperative complications after abdominal surgery. Am Surg 2004;70:347-351.
  21. Gretschel S, Christoph F, Bembenek A, Estevez-Schwarz L, Schneider U, Schlag PM. Body mass index does not affect systematic D2 lymph node dissection and postoperative morbidity in gastric cancer patients. Ann Surg Oncol 2003;10:363-368. https://doi.org/10.1245/ASO.2003.07.011
  22. Lee JH, Paik YH, Lee JS, Ryu KW, Kim CG, Park SR, et al. Abdominal shape of gastric cancer patients influences short-term surgical outcomes. Ann Surg Oncol 2007;14:1288-1294. https://doi.org/10.1245/s10434-006-9235-1

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