Ann Surg Treat Res.  2015 Jun;88(6):318-324. 10.4174/astr.2015.88.6.318.

Effect of visceral fat area on outcomes of laparoscopyassisted distal gastrectomy for gastric cancer: subgroup analysis by gender and parameters of obesity

• Go JE
• Kim MC
• Kim KH
• Oh JY
• Kim YM

• KMID: 1800645
• DOI: http://doi.org/10.4174/astr.2015.88.6.318

Abstract

PURPOSE
The aim of this study was to investigate the impact of the visceral fat area (VFA) of patients with gastric cancer undergoing laparoscopic surgery on operative outcomes such as number of retrieved lymph nodes (LNs) and operative time.
METHODS
We retrospectively reviewed the medical records and the CT scans of 597 patients with gastric cancer who underwent laparoscopy assisted distal gastrectomy (LADG) with partial omentectomy and LN dissection (>D1 plus beta). Patients were stratified by gender, VFA, and body mass index (BMI), and the clinicopathologic characteristics and operative outcomes were evaluated. Multiple linear regression analysis was used to assess the effects of VFA and BMI on the number of retrieved LNs and operative time in male and female patients.
RESULTS
The mean number of retrieved LNs was significantly decreased for both male and female patients with high VFA. The operative time was significantly longer for both male and female patients with high VFA. The number of retrieved LNs had a statistically significant negative correlation with VFA in both men and women, but not with BMI. The operative time had a statistically significant positive correlation with VFA in men, whereas the operative time had a statistically significant positive correlation with BMI in women.
CONCLUSION
The preoperative VFA of male patients with gastric cancer who undergo LADG may affect the number of retrieved LNs and operative time. VFA was more useful than BMI for predicting outcomes of LADG.

Keyword

Stomach neoplasms; Laparoscopy; Visceral fat; Body mass index

MeSH Terms

Body Mass Index
Female
Gastrectomy*
Humans
Intra-Abdominal Fat*
Laparoscopy
Linear Models
Lymph Nodes
Male
Medical Records
Obesity*
Operative Time
Retrospective Studies
Stomach Neoplasms*
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Distribution of the values of the visceral fat area of gastric cancer patients (n = 597) according to gender. Both genders have normal distribution, with mean values in men (A) and women (B) of 100.3 cm2 and 78.9 cm2, respectively (Axis x = distribution of the values of the visceral fat area, axis y = number of patients).

• 

  Fig. 2 The mean number of retrieved lymph nodes (LNs) according to gender, body mass index (BMI), and visceral fat area (VFA) of patients with gastric cancer undergoing laparoscopic surgery. There was a statistically significant difference in the mean number of retrieved lymph nodes between the 4 subgroups of both men and women (men, P < 0.001; women, P = 0.013). BMI_L, low BMI; BML_H, high BMI; VFA_L, low VFA; VFA_H, high VFA.

• 

  Fig. 3 The mean operative time according to gender, body mass index (BMI), and visceral fat area (VFA) of patients with gastric cancer undergoing laparoscopic surgery. There was a statistically significant difference between 4 subgroups in men, only. BMI_L, low BMI; BML_H, high BMI; VFA_L, low VFA; VFA_H, high VFA.

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