Obesity and outcome of distal gastrectomy with D2 lymphadenectomy for carcinoma.

要旨

BACKGROUND/AIMS: Obesity has correlated with surgical outcome in patients undergoing elective surgery for various cancers. This relationship has not been examined for gastric cancer surgery performed at a specialized high-volume center. METHODOLOGY: Data from 562 consecutive patients treated with potentially curative distal gastrectomy between 1993 and 1999 were used. Patients were assigned to 2 groups according to a combination of Japanese and Western criteria for obesity (group A, body mass index < 25 for men and < 22 for women; or group B, body mass index > or = 27). Relationships between obesity and clinical variables were analyzed. RESULTS: Two hundred and five patients (29.4%) were obese by Japanese cutoff values; only 50 (7.2%) were obese by Western standards. A significant difference in blood loss and operative time was noted between groups. Intra-abdominal infection was more frequent for group B, leading to significantly longer hospitalization. Lymph node yield was significantly smaller in group B, but no influence of obesity on long-term survival was observed. CONCLUSIONS: Obesity can increase duration of surgery, volume of blood loss, and incidence of surgical complications, but does not affect long-term survival.

主題