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Impact of visceral fat obesity (obesity disease) on short- and long-term outcomes of laparoscopic gastrectomy in gastric cancer.
Yamamoto, Kei; Oka, Yoshio; Takada, Naoya; Murao, Shuhei; Higashiguchi, Masaya; Takeda, Takashi; Fukata, Tadafumi; Noguchi, Kozo; Danno, Katsuki; Toyoda, Yasuhiro; Nakane, Shigeru; Yamamoto, Hitoshi; Saeki, Mika; Mito, Takeshi; Fujino, Shiki; Hirao, Takafumi.
Afiliación
  • Yamamoto K; Department of Surgery, Minoh City Hospital, Osaka, Japan.
  • Oka Y; Department of Surgery, Minoh City Hospital, Osaka, Japan.
  • Takada N; Department of Surgery, Minoh City Hospital, Osaka, Japan.
  • Murao S; Department of Surgery, Minoh City Hospital, Osaka, Japan.
  • Higashiguchi M; Department of Surgery, Minoh City Hospital, Osaka, Japan.
  • Takeda T; Department of Surgery, Minoh City Hospital, Osaka, Japan.
  • Fukata T; Department of Surgery, Minoh City Hospital, Osaka, Japan.
  • Noguchi K; Department of Surgery, Minoh City Hospital, Osaka, Japan.
  • Danno K; Department of Surgery, Minoh City Hospital, Osaka, Japan.
  • Toyoda Y; Department of Surgery, Minoh City Hospital, Osaka, Japan.
  • Nakane S; Department of Surgery, Minoh City Hospital, Osaka, Japan.
  • Yamamoto H; Department of Surgery, Minoh City Hospital, Osaka, Japan.
  • Saeki M; Department of Radiology, Minoh City Hospital, Osaka, Japan.
  • Mito T; Department of Radiology, Minoh City Hospital, Osaka, Japan.
  • Fujino S; Department of Gastroenterology, Central Clinical School, Monash University, Victoria, Australia.
  • Hirao T; Department of Surgery, Minoh City Hospital, Osaka, Japan.
Asian J Endosc Surg ; 17(4): e13374, 2024 Oct.
Article en En | MEDLINE | ID: mdl-39191401
ABSTRACT

BACKGROUND:

As the incidence of obesity increases worldwide, laparoscopic gastrectomy (LG) in obese patients with gastric cancer is more common. It is unclear how visceral fat obesity (obesity disease [OD]) may influence short- and long-term outcomes after LG.

METHODS:

This study included 170 gastric cancer patients who underwent curative LG at Minoh City Hospital from 2008 to 2020. Patients were classified based on preoperative body mass index (BMI) and visceral fat area (VFA) normal (N; n = 95), visceral fat accumulation alone (VF; n = 35), obesity with visceral fat accumulation (OD; n = 35), and obesity alone (n = 5).

RESULTS:

Compared with normal VFA, high preoperative VFA (≥100 cm2) was significantly associated with longer operation time, greater blood loss, more frequent postoperative complications, and longer hospital stay. Multivariate analysis revealed the following independent risk factors for postoperative intra-abdominal infectious complications Charlson Comorbidity Index ≥4 (odds ratio [OR] 3.1, 95% confidence interval [CI] 1.2-8.5), dissected lymph node area (D2) (OR 3.0, 95% CI 1.2-7.1), and preoperative VFA (≥100 cm2) (OR 3.7, 95% CI 1.6-8.8). Intraoperative and postoperative courses were comparable between groups VF and OD. The 3-year overall survival rate was significantly worse in group VF (73.2%) compared with groups OD (96.7%) and N (96.7%) (p < .0001). Recurrence-free survival and cancer-specific survival were comparable between groups VF, OD, and N.

CONCLUSION:

Visceral fat accumulation strongly predicted postoperative morbidity. Despite increased perioperative risk, OD did not negatively impact successful lymphadenectomy or survival following LG.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Neoplasias Gástricas / Laparoscopía / Grasa Intraabdominal / Gastrectomía Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Asian J Endosc Surg Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Neoplasias Gástricas / Laparoscopía / Grasa Intraabdominal / Gastrectomía Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Asian J Endosc Surg Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón