Safety and efficacy of laparoscopic gastrectomy in obese patients with gastric cancer
Safety and efficacy of laparoscopic gastrectomy in obese patients with gastric cancer
复制标题
肥胖胃癌患者腹腔镜胃切除术的安全性和有效性
DOI：
10.1097/md.0000000000017991
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发表时间：
2019-11-01
期刊：
影响因子：
1.6
通讯作者：
Su, Xiangqian
中科院分区：
文献类型：
--
作者：
Liu, Maoxing;Xing, Jiadi;Su, Xiangqian
摘要本研究旨在探讨腹腔镜辅助下远端胃癌根治术治疗肥胖患者的安全性和短期疗效。比较67例体重指数（BMI）≥25 kg/m2（肥胖组）和198例BMI <25 kg/m2（非肥胖组）的胃癌患者的围手术期结局。 所有病例均于2009年4月至2013年10月期间接受腹腔镜根治性切除术。肥胖组BMI为27.3 ± 2.67 kg/m2，非肥胖组BMI为21.3± 2.64 kg/m2。 两组在年龄、性别、糖尿病、肿瘤大小、转移淋巴结数量或转移淋巴结比率方面无显著差异。两组的术后并发症无差异（P> 0.05）。 两组之间的手术时间（非肥胖组：[234.2 ± 67.1]分钟vs肥胖组：[259.4 ± 78.5]; P = 0.017）、术后住院时间（肥胖组[19.7 ± 14.8]天vs非肥胖组[15.4 ± 7.1]，P = 0.002）和淋巴结取出时间（[27.6 ± 11.0]天vs非肥胖组[31.9 ± 12.5]天，P = 0.002）存在显著差异。 肥胖可能延长手术时间和术后住院时间，导致淋巴结回收少，但不增加术后并发症的发生率。经验丰富的中心可以适当地对肥胖患者进行腹腔镜辅助根治性胃切除术。
Abstract The present study aimed to investigate the safety and short-term outcome of laparoscopy-assisted distal radical gastrectomy in treating gastric cancer among obese patients. Perioperative outcomes were compared between 67 gastric cancer patients with a body mass index (BMI) ≥25 kg/m2 (obese group) and 198 ones with BMI <25 kg/m2 (non-obese group). All the cases underwent laparoscopic radical resection between April 2009 and October 2013. The value of BMI was 27.3 ± 2.67 kg/m2 in the obese group and 21.3 ± 2.64 kg/m2 in non-obese group. There were no significant differences between 2 groups in age, sex, presence of diabetes, tumor size, number of metastatic lymph nodes, or metastatic lymph node ratio. Postoperative complications did not differ between the 2 groups (P > .05). There were significant differences between the 2 groups in operation time (non-obese: [234.2 ± 67.1] minutes vs obese group: [259.4 ± 78.5]; P = .017), postoperative hospital stay (obese group [19.7 ± 14.8] day vs non-obese [15.4 ± 7.1], P = .002), and retrieved lymph nodes ([27.6 ± 11.0] day vs non-obese [31.9 ± 12.5] day, P = .002). Obesity may prolong operation time and postoperative hospital stay, and cause less retrieved lymph nodes, but does not increase the incidence of postoperative complications. The experienced center can properly conduct laparoscopic assisted radical gastrectomy in obese patients.