J Gastric Cancer.  2014 Sep;14(3):187-195. 10.5230/jgc.2014.14.3.187.

Laparoscopic Distal Gastrectomy for Gastric Cancer in Morbidly Obese Patients in South Korea

• Jung JH
• Ryu SY
• Jung MR
• Park YK
• Jeong O

• KMID: 2372530
• DOI: http://doi.org/10.5230/jgc.2014.14.3.187

Abstract

PURPOSE
Laparoscopic gastrectomy in obese patients has been investigated in several studies, but its feasibility has rarely been examined in morbidly obese patients, such as in those with a body mass index (BMI) of > or =30 kg/m2. The present study aimed to evaluate the technical feasibility and safety of laparoscopic gastrectomy in morbidly obese patients with gastric cancer.
MATERIALS AND METHODS
A total of 1,512 gastric cancer patients who underwent laparoscopic distal gastrectomy (LDG) were divided into three groups: normal (BMI<25 kg/m2, n=996), obese (BMI 25~30 kg/m2, n=471), and morbidly obese (BMI> or =30 kg/m2, n=45). Short-term surgical outcomes, including the course of hospitalization and postoperative complications, were compared between the three groups.
RESULTS
The morbidly obese group had a significantly longer operating time (240 minutes vs. 204 minutes, P=0.010) than the normal group, but no significant differences were found between the groups with respect to intraoperative blood loss or other complications. In the morbidly obese group, the postoperative morbidity and mortality rates were 13.3% and 0%, respectively, and the mean length of hospital stay was 8.2 days, which were not significantly different from those in the normal group. Subgroup analysis showed that postoperative complication rates were not high in morbidly obese patients, independent of the type of anastomosis technique used and level of lymph node dissection.
CONCLUSIONS
LDG is technically feasible and safe in morbidly obese patients with a BMI of > or =30 kg/m2 and early gastric carcinoma. Except for a longer operating time, LDG might represent a reasonable treatment option in these patients.

Keyword

Stomach neoplasms; Laparoscopy; Gastrectomy; Morbid obesity; Morbidity

MeSH Terms

Body Mass Index
Gastrectomy*
Hospitalization
Humans
Korea
Laparoscopy
Length of Stay
Lymph Node Excision
Mortality
Obesity, Morbid
Postoperative Complications
Stomach Neoplasms*

Figure

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  Fig. 1 Subgroup analysis for the effect of morbid obesity on the risk of postoperative complications. Morbid obesity did not increase the postoperative complications in any subgroup, regardless of the extent of lymph node dissection (LND), the types of reconstruction procedure, or the presence of omentectomy. OR = odds ratio; CI = confidence interval.

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