Laparoscopic Distal Gastrectomy for Gastric Cancer in Morbidly Obese Patients in South Korea.
10.5230/jgc.2014.14.3.187
- Author:
Ji Hoon JUNG
1
;
Seong Yeop RYU
;
Mi Ran JUNG
;
Young Kyu PARK
;
Oh JEONG
Author Information
1. Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Hwasun Hospital, Hwasun, Korea. surgeonjeong@gmail.com
- Publication Type:Original Article
- Keywords:
Stomach neoplasms;
Laparoscopy;
Gastrectomy;
Morbid obesity;
Morbidity
- MeSH:
Body Mass Index;
Gastrectomy*;
Hospitalization;
Humans;
Korea;
Laparoscopy;
Length of Stay;
Lymph Node Excision;
Mortality;
Obesity, Morbid;
Postoperative Complications;
Stomach Neoplasms*
- From:Journal of Gastric Cancer
2014;14(3):187-195
- CountryRepublic of Korea
- Language:English
-
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.
