Jung Ho Shim1, Kyo Young Song, Seung Nam Kim, Cho Hyun Park. 1. Department of Surgery, College of Medicine, The Catholic University of Korea, Kangnam St. Mary's Hospital, 505 Banpo-dong, Seocho-gu, Seoul, 137-701, Republic of Korea.
Abstract
PURPOSE: It is generally considered difficult to operate on overweight patients, who are also at increased risk of postoperative complications. We conducted this study to clarify the technical feasibility and postoperative outcomes of laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer (EGC) in overweight patients. METHODS: Between July 2004 and December 2006, 116 patients with preoperatively diagnosed EGC underwent LADG at our department. We classified these patients into two groups based on body mass index (BMI). There were 60 patients in the high-BMI (> or =23 kg/m2) group and 56 in the low-BMI (<23 kg/m2) group. The clinicopathologic features, postoperative outcomes, and operation-related morbidities were compared. RESULTS: None of the patients needed conversion to laparotomy. There were no notable differences in clinical characteristics or histologic features between the groups. Although the operation time was significantly longer in the high-BMI group, there were no significant differences in postoperative bowel recovery, postoperative hospital stay, or operation-related morbidities. CONCLUSIONS: Laparoscopy-assisted distal gastrectomy for overweight patients is feasible and safe; however, because of its technical difficulties and the complexities of lymph node dissection, it should be carefully considered, and may only be suitable for early-stage cancers.
PURPOSE: It is generally considered difficult to operate on overweight patients, who are also at increased risk of postoperative complications. We conducted this study to clarify the technical feasibility and postoperative outcomes of laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer (EGC) in overweight patients. METHODS: Between July 2004 and December 2006, 116 patients with preoperatively diagnosed EGC underwent LADG at our department. We classified these patients into two groups based on body mass index (BMI). There were 60 patients in the high-BMI (> or =23 kg/m2) group and 56 in the low-BMI (<23 kg/m2) group. The clinicopathologic features, postoperative outcomes, and operation-related morbidities were compared. RESULTS: None of the patients needed conversion to laparotomy. There were no notable differences in clinical characteristics or histologic features between the groups. Although the operation time was significantly longer in the high-BMI group, there were no significant differences in postoperative bowel recovery, postoperative hospital stay, or operation-related morbidities. CONCLUSIONS: Laparoscopy-assisted distal gastrectomy for overweight patients is feasible and safe; however, because of its technical difficulties and the complexities of lymph node dissection, it should be carefully considered, and may only be suitable for early-stage cancers.