-Original-

The Influences of Obesity in Laparoscopic and Open Distal Gastrectomy for Patients with Early Gastric Cancer

Kentaro Maejima^1,2, Nobuhiko Taniai² and Hiroshi Yoshida³

¹Department of Surgery, Hasuda Hospital, Saitama, Japan
²Department of Digestive Surgery, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan
³Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Hospital, Tokyo, Japan

Background: A recent increase in the number of surgeries performed on obese patents has raised several issues. In this study, we examined the effects of obesity on laparoscopic and open distal gastrectomy.
Methods: A total of 262 patients with gastric cancer (cStage I) who underwent distal gastrectomy were classified into open distal gastrectomy (ODG) (145 patients) and laparoscopic distal gastrectomy (LDG) (117 patients) groups. According to their body mass index (BMI), they were subdivided into obese (BMI ≥ 25) and non-obese patients (BMI < 25) to examine the duration of surgery, blood loss, the number of lymph node dissections, postoperative hospital stay, and incidence of postoperative complications.
Results: The duration of surgery was longer and blood loss was higher for obese patients than for non-obese patients in both groups. The results for these two endpoints were significantly reduced in the LDG group than in the ODG group both in obese and non-obese patients. Furthermore, the number of lymph nodes dissected tended to be higher in the LDG group than in the ODG group in obese patients. Postoperative hospital stay was not significantly different between obese and non-obese patients in both groups, but was significantly shorter in the LDG group than in the ODG group regardless of the body weight. The incidence of postoperative complications was significantly higher in obese patients than in non-obese patients, although the difference between the groups was not significant.
Conclusions: These findings indicate that LDG may be useful for obese patients with cStage I gastric cancer.

J Nippon Med Sch 2022; 89: 215-221

Keywords
obesity, gastric cancer, laparoscopic surgery

Correspondence to
Kentaro Maejima, Department of Surgery, Hasuda Hospital, 1-1662 Negane, Hasuda, Saitama 349-0131, Japan
ken3363-attacker@nms.ac.jp

Received, March 24, 2021
Accepted, June 11, 2021