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01-04-2009 | original article

Increased Fat Content and Body Shape Have Little Effect on the Accuracy of Lymph Node Retrieval and Blood Loss in Laparoscopic Distal Gastrectomy for Gastric Cancer

Authors: Naoki Hiki, Tetsu Fukunaga, Toshiharu Yamaguchi, Toshihiro Ogura, Satoshi Miyata, Masanori Tokunaga, Shigekazu Ohyama, Takeshi Sano

Published in: Journal of Gastrointestinal Surgery | Issue 4/2009

Abstract

Background

Fat volume and large abdominal shape are known to disrupt the procedures of lymph node retrieval used in gastric cancer surgery. The present study examined the effect of increasing fat content on surgical outcomes, including estimated blood loss and the number of lymph nodes retrieved during gastrectomy.

Methods

Of 154 patients, 50 underwent the conventional open procedure (OPEN) and 104 underwent laparoscopy-assisted distal gastrectomy (LADG). The BMI-related factors of total fat, subcutaneous fat, and visceral fat area, as well as the peritoneum–celiac axis distance were calculated by computed tomography. Regression analysis was used to determine the effects of BMI-related factors that obstruct the surgical procedures on the specific outcomes of estimated blood loss and the number of lymph nodes retrieved.

Results

In the OPEN, but not in the LADG, increases in all BMI-related factors were related to increases in estimated blood loss. The increases in BMI, subcutaneous fat, and the peritoneum-celiac axis distances were related to decreased numbers of retrieved lymph nodes only in the OPEN. Only the factor of visceral fat at the celiac level was modestly associated with a decreased number of dissected lymph node in both groups.

Conclusions

The present study demonstrated that increased fat content and large body shape have little effect on the number of lymph nodes retrieved and blood loss in LADG. However, for patients undergoing conventional open distal gastrectomy, increased fat content and large body shape do impact on the amount of blood lost and the number of lymph nodes retrieved.

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Title: Increased Fat Content and Body Shape Have Little Effect on the Accuracy of Lymph Node Retrieval and Blood Loss in Laparoscopic Distal Gastrectomy for Gastric Cancer
Authors: Naoki Hiki
Tetsu Fukunaga
Toshiharu Yamaguchi
Toshihiro Ogura
Satoshi Miyata
Masanori Tokunaga
Shigekazu Ohyama
Takeshi Sano
Publication date: 01-04-2009
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 4/2009
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-008-0768-4

At a glance: The STEP trials

Springer Medicine

Increased Fat Content and Body Shape Have Little Effect on the Accuracy of Lymph Node Retrieval and Blood Loss in Laparoscopic Distal Gastrectomy for Gastric Cancer

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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