Safety and efficacy of laparoscopic gastrectomy in obese patients with gastric cancer

Abstract

The present study aimed to investigate the safety and short-term outcome of laparoscopy-assisted distal radical gastrectomy in treating gastric cancer among obese patients. Perioperative outcomes were compared between 67 gastric cancer patients with a body mass index (BMI) ≥25 kg/m2 (obese group) and 198 ones with BMI <25 kg/m2 (non-obese group). All the cases underwent laparoscopic radical resection between April 2009 and October 2013. The value of BMI was 27.3 ± 2.67 kg/m2 in the obese group and 21.3 ± 2.64 kg/m2 in non-obese group. There were no significant differences between 2 groups in age, sex, presence of diabetes, tumor size, number of metastatic lymph nodes, or metastatic lymph node ratio. Postoperative complications did not differ between the 2 groups (P > .05). There were significant differences between the 2 groups in operation time (non-obese: [234.2 ± 67.1] minutes vs obese group: [259.4 ± 78.5]; P = .017), postoperative hospital stay (obese group [19.7 ± 14.8] day vs non-obese [15.4 ± 7.1], P = .002), and retrieved lymph nodes ([27.6 ± 11.0] day vs non-obese [31.9 ± 12.5] day, P = .002). Obesity may prolong operation time and postoperative hospital stay, and cause less retrieved lymph nodes, but does not increase the incidence of postoperative complications. The experienced center can properly conduct laparoscopic assisted radical gastrectomy in obese patients.

Safety of subxiphoid uniportal video-assisted thoracoscopic surgery for anterior mediastinal tumour in obese patients.

“…Some researchers demonstrated that obesity is an important risk factor for postoperative complications, and the rate of postoperative complication in obese patients is higher than that in patients with normal weight [11][12][13][14]. However, some other researchers disagreed with that and pointed out that obesity did not affect postoperative complications in some surgery [15][16][17][18]. So far, whether a higher BMI can compromise surgical outcomes via subxiphoid uniportal VATS in patients with AMT is unclear.…”

Laparoscopic gastrectomy reduces adverse postoperative outcomes and decreases morbidity for gastric cancer patients with visceral obesity: a propensity score-matched analysis

“…Notably, China has the largest number of overweight people (more than 89.6 million in 2014) 21 . Problems related to obesity have attracted an increasing amount of attention from surgical specialists since a large amount of adipose tissue in the abdominal wall and the abdominal cavity greatly increases the difficulty of exposing the operative field in laparotomy 4 . Studies also indicate that, compared with non-obese patients, obese patients experience significantly longer operation times, more intraoperative blood loss, and are more likely to develop postoperative complications after abdominal operation 4 , 20 .…”

“…Problems related to obesity have attracted an increasing amount of attention from surgical specialists since a large amount of adipose tissue in the abdominal wall and the abdominal cavity greatly increases the difficulty of exposing the operative field in laparotomy [4]. Studies also indicate that, compared with non-obese patients, obese patients experience significantly longer operation times, more intraoperative blood loss, and are more likely to develop postoperative complications after abdominal operation [4,20]. Considering the priority of VO over BMI in several studies [11,20], we used CT-based-VFA for determining VO in this study and observed a high incidence of VO in patients with GC (42.61%).…”

“…Gastric cancer (GC) is the fourth most common cancer worldwide and the third leading cause of cancer-related mortality, with 723,000 deaths annually 1 , 2 . Obesity has been reported to be associated with poor surgical outcomes in GC, including fewer lymph node dissections and more postoperative complications 3 , 4 . Traditionally, body mass index (BMI) has been broadly used to indicate obesity 5 , 6 .…”

“…However, the thicker abdominal wall in obese individuals increases the operation difficulty and postoperative infection risk. Studies have also shown that obesity may be a contraindication for laparoscopic surgery 4 . There is still a lack of clinical evidence whether laparoscopic radical gastrectomy can reduce the surgical stress and improve the short- and long-term outcomes of obese patients with GC.…”