The Impact of Obesity on Operative Results and Postoperative Courses in Laparoscopic-assisted Distal Gastrectomy (LADG)

Cheong, Oh; Kim, Byung Sik; Oh, Sung Tae; Yook, Jeong Hwan; Lim, Jung Taek; Park, Gun Chun; Choi, Ji Eun; Kim, Kap Jung

Abstract

PURPOSE: Despite known advantages of laparoscopy-assisted distal gastrectomy (LADG) over open surgery, including less blood loss, less pain, faster recovery, and shorter hospital stays, many surgeons still hesitate to perform LADG in overweight patients due to concerns about increased perioperative morbidity. We investigated whether surgical outcomes in LADG differ in overweight patients and normal patients, as well as the influence of surgical experience.
METHODS
Between April 2004 and December 2006, 331 consecutive patients underwent LADG for preoperatively diagnosed early gastric cancer. Using the definition of overweight by western criteria, patients were classified into a low (n = 187, BMI < 25 kg/m(2)) and a high (n=144, BMI > 25 kg/m(2)) group. We retrospectively analyzed surgical outcomes, including operation time, retrieved lymph nodes, hospital courses, and postoperative complications.
RESULTS
The only differences in overweight and normal patients were longer operation time, incision length, and fewer retrieved lymph nodes. As our surgical team accumulated experience (after 250 cases in our study), there were no differences at all between the two groups.
CONCLUSION
Technical difficulty in overweight patients could hamper some surgical outcomes but didn't worsen the post- operative courses or complications. Moreover, those difficulties can be overcome as the surgical team accumulates experience.