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An Analysis of 689 Consecutive Cases Managed by a Single Center

Toshiyasu Ojima, MD; Makoto Iwahashi, MD; Mikihito Nakamori, MD; Masaki Nakamura, MD; Teiji Naka, MD; Koichiro Ishida, MD; Kentaro Ueda, MD; Masahiro Katsuda, MD; Takeshi Iida, MD; Toshiaki Tsuji, MD; Hiroki Yamaue, MD

Arch Surg. 2009;144(4):351-358.

Hypothesis  Overweight (body mass index [calculated as weight in kilograms divided by height in meters squared], 25.0) has an effect on surgical results, postoperative complications, and long-term survival in patients with gastric cancer who underwent curative gastrectomy.

Design  Retrospective study from January 1, 1992, through December 31, 2002.

Setting  Wakayama Medical University Hospital.

Patients  This study included 689 patients who underwent curative gastrectomy (R0). Patients who underwent laparoscopic gastrectomy, gastrectomy with pancreaticoduodenectomy, gastrectomy with another organ resection (liver, colon, or ovary), or gastrectomy with thoracotomy were not included.

Main Outcome Measures  Duration of operation, amount of blood loss, incidence of postoperative complications, and survival analysis.

Results  The mean (SD) duration of the operation was longer in the overweight group (315 [75] minutes) than in the normal-weight group (277 [85] minutes) (P < .001). The mean (SD) intraoperative blood loss was larger in the overweight group (882 [764] mL) than in the normal-weight group (536 [410] mL) (P < .001). The rates of postoperative complications (anastomotic leakage, pancreatic fistula, and intra-abdominal abscess) were significantly higher in the overweight group (P < .05). Multivariate logistic regression analysis identified that postoperative complications were significantly associated with being overweight (P = .01) and with undergoing pancreatectomy (P = .03). Disease-specific and overall survival did not show any significant difference between the 2 groups.

Conclusions  Being overweight is not a poor risk factor for survival in patients with gastric cancer, although it is independently predictive of postoperative complications.

Author Affiliations: Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama, Japan.

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Arch Surg. 2009;144(4):358.
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