Published online Dec 26, 2018. doi: 10.12998/wjcc.v6.i16.1094
Peer-review started: August 23, 2018
First decision: October 5, 2018
Revised: October 16, 2018
Accepted: November 23, 2018
Article in press: November 24, 2018
Published online: December 26, 2018
While the proportion of gastric cancer in upper third stomach is increasing, increased number of overweight (OW) patients is an important health issue. Consequently, laparoscopic total gastrectomy (LTG) to OW patients is increasing.
Total gastrectomy and OW seems among the worst combinations for the laparoscopic approach. However, whether OW really has a worse impact on LTG compared to open total gastrectomy remains unknown.
The main objectives of this retrospective study were to investigate safety and oncological feasibility of LTG in OW patients.
Propensity score matching selected 152 patients (76 laparoscopic, 76 open), from 321 patients who underwent total gastrectomy from 1999 to 2016. The patients were subsequently divided into the OW (≥ 25) or non-OW (< 25) group by body mass index. Postoperative outcomes of laparoscopic versus open approaches were compared between OW and non-OW groups.
In the laparoscopy group, operative time was longer (P = 0.01) in the OW group, however, other perioperative results were comparable between the non-OW and OW groups. In the open group, number of retrieved lymph nodes were less (P = 0.03) and local complication rate was more frequent (P = 0.03) in the OW group.
LTG in OW patients remains technically challenging but can be performed safely. Our findings imply that OW has a lesser effect on the laparoscopic versus open approach to total gastrectomy.
Laparoscopic approach can be a choice for total gastrectomy in OW patients in experienced institutions.