Effect of Obesity on Laparoscopy-Assisted Distal Gastrectomy Compared With Open Distal Gastrectomy for Gastric Cancer

Background and Objectives: This study compared surgical outcomes between patients undergoing laparoscopy-assisted distal gastrectomy (LADG) and those undergoing open distal gastrectomy (ODD) from the viewpoint of obesity. Methods: Between June 2002 and May 2008, 146 patients with preoperatively diagnosed early gastric cancer who underwent LADG (n = 90) or ODD (n = 56) were enrolled in this study and compared in terms of clinicopathological findings and operative outcome. The visceral fat area (VFA) and subcutaneous fat area (SFA) were assessed as identifiers of obesity using Fat Scan software. The relationship between obesity and operative outcomes after LADG and ODD was evaluated. Results: There were no significant correlations between intraoperative blood loss (IBL) and any obesity-related factors, or between operation time (OT) and any obesity-related factors in the LADG group. There was a significant correlation between IBL and BMI (r = 0.486, P = 0.0001), IBL and VFA (r = 0.456, P = 0.0003), IBL and SPA (r = 0.311, P = 0.0193), OT and BMI (r = 0.406, P= 0.0017), OT and VFA (r = 0.314, P = 0.0178), and between OT and SFA (r = 0.382, P = 0.0034) in the ODG group. Conclusions: LADG may be a useful operative manipulation that is not influenced by obesity, whereas ODG may be influenced by obesity even after reaching the surgical plateau. J. Surg. Oncol. 2010:102:141-147. (C) 2010 Wiley-Liss, Inc.