Feasibility of laparoscopic total gastrectomy in overweight patients: Implications of less impact of overweight on laparoscopic versus open approach

Table 1 Baseline characteristics of enrolled patients

		All patients			Matched patients
		LTG (n = 110)	OTG (n = 211)	P -values	LTG (n = 76)	OTG (n = 76)	P-values
Gender	Male	81	162	0.53	55	62	0.18
	Female	29	78		21	14
Age (median, range)		70 (32-83)	69 (17-86)	0.92	70 (32-83)	71 (17-86)	0.53
BMI (kg/m2) (median, range)		23.2 (15.8-31.0)	22.2 (13.6-38.3)	0.07	21.9 (15.8-30.4)	27.4 (13.6-35.4)	0.35
period	Early	39	148	< 0.01	39	28	0.07
	Late	71	63		37	48
Extent of lymph node dissection	D2 <	91	120	< 0.01	57	53	0.47
	D2	22	142		19	23
Splenectomy	Yes	14	99	< 0.01	14	19	0.33
	No	96	112		62	57
Tumor size (mm) (median, range)		45 (6-200)	70 (13-230)	< 0.01	52 (6-200)	59 (14-213)	0.14
pT	M	21	7	< 0.01	9	6	0.49
	SM	34	23		21	17
	MP	19	15		11	8
	SS	20	71		19	20
	SE	16	89		16	22
	SI	0	5		0	2
pN	N0	65	63	< 0.01	38	36	0.38
	N1	19	30		13	7
	N2	13	40		12	12
	N3a	9	48		9	12
	N3b	4	30		4	9
pStage	I	66	37	< 0.01	35	32	0.20
	II	20	51		17	9
	III	19	93		19	27
	IV	5	30		5	8

OTG: Open total gastrectomy; LTG: Laparoscopic total gastrectomy; BMI: Body mass index.

Table 2 Baseline characteristics of non-overweight and overweight groups in both laparoscopy and open groups

		LTG (n = 76)			OTG (n = 76)
		non-OW (n = 57)	OW (n = 19)	P -values	non-OW (n = 63)	OW (n = 13)	P-values
Gender	Male	42	13	0.66	52	10	0.45
	Female	15	6		11	3
Age (median, range)		70 (40-83)	64 (32-79)	0.06	72 (17-80.6)	71 (29-79)	0.73
BMI (median, range)		21.2 (15.8-24.8)	26.6 (25.2-30.4)	< 0.01	20.9 (13.6-24.9)	27.6 (25.0-35.4)	< 0.01
Extent of lymph node dissection	< D2	42	15	0.42	42	11	0.17
	D2 ≤	15	4		21	2
Splenectomy	Yes	11	3	0.73	17	2	0.31
	No	46	16		46	11
Tumor size (mm) (median, range)		56 (6-185)	50 (7-200)	0.43	53 (14-211)	75 (25-210)	0.25
Depth of tumor	M	7	2	0.11	6	0	0.37
	SM	15	6		12	5
	MP	5	6		7	1
	SS	16	3		18	2
	SE	14	2		18	4
	SI	0	0		1	1
Lymph node classification	N0	26	12	0.43	30	6	0.85
	N1	9	4		6	1
	N2	10	2		9	3
	N3a	8	1		11	1
	N3b	4	0		7	2
pStage	I	25	10	0.34	26	6	0.51
	II	11	6		9	0
	III	17	2		22	5
	IV	4	1		6	2

OTG: Open total gastrectomy; LTG: Laparoscopic total gastrectomy; BMI: Body mass index; non-OW: Non-overweight group; OW: Overweight group.

Table 3 Perioperative results of non-overweight and overweight groups in both open and laparoscopy groups

		LTG (n = 76)			OTG (n = 76)
		non-OW(n = 57)	OW(n = 19)	P-values	non-OW(n = 63)	OW(n = 13)	P -values
Operative time (min) (median, range)		332 (209-541)	400 (230-520)	0.01	265 (134-810)	276 (195-460)	0.32
Estimated intraoperative blood loss (mL) (median, range)		188 (0-2492)	202 (0-1714)	0.63	445 (90-3406)	780 (104-1980)	0.14
No. of retrieved lymph nodes (median, range)		43 (8-71)	36 (14-117)	0.4	41 (9-89)	29 (2-49)	0.03
Morbidity (%)	Overall	13 (23)	5 (26)	0.49	23 (37)	8 (62)	0.1
	Local	7 (12)	5 (26)	0.14	14 (22)	7 (54)	0.03
	Systemic	8 (14)	3 (16)	0.56	13 (21)	4 (31)	0.32
	Severe	5 (9)	3 (11)	0.56	8 (13)	4 (31)	0.12
	Anastomotic Leakage	3 (5)	3 (16)	0.16	2 (3)	3 (23)	0.03
	Anastomotic stricture	1 (2)	1 (5)	0.44	1 (2)	1 (8)	0.32
	Pancreatic fistula	3 (5)	0 (0)	0.42	3 (5)	2 (15)	0.2
	Abdominal abscess	2 (4)	0 (0)	0.56	3 (5)	2 (15)	0.2
	pulmonary	5 (9)	2 (11)	0.90	9 (14)	1 (8)	0.46
	Wound infection	1 (2)	1 (5)	0.44	3 (5)	2 (15)	0.2
POH (d) (median, range)		9 (6-74)	9 (6-73)	0.75	14 (7-159)	19 (10-145)	0.1

OTG: Open total gastrectomy; LTG: Laparoscopic total gastrectomy; BMI: Body mass index; non-OW: Non-overweight group; OW: Overweight group; POH: Postoperative hospital stay.