Kim Jieun, An Ji Yeong, Choi Min-Gew, Sohn Tae Sung, Bae Jae Moon, Kim Sung, Lee Jun Ho
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea.
Surg Laparosc Endosc Percutan Tech. 2018 Apr;28(2):96-101. doi: 10.1097/SLE.0000000000000511.
The aim of this study was to evaluate the impact of surgical experience on laparoscopic distal gastrectomy in high body mass index (BMI) patients. Retrospective data were collected on patients who underwent laparoscopic distal gastrectomy for early gastric cancer from July 2002 to December 2014. Patients were divided into a high BMI group (BMI≥25 kg/m) and a low BMI group (BMI<25 kg/m) and classified into subgroups by surgeon experience. Patient characteristics and surgical outcomes between groups were analyzed and compared. Mean operation time in the high BMI group was longer than the low BMI group (173.0±52.5 vs. 164.2±48.0 min; P=0.009). Subgroup analysis showed longer operation time in the high BMI group than the low BMI group (200.8±49.3 vs. 187.9±45.2 min; P<0.001) and fewer retrieved lymph nodes (36.3±11.7 vs. 33.0±13.1; P=0.004) in the early surgeon experience period. Patients in the late experience period showed no significant differences in surgical outcomes between the high BMI and low BMI group. High BMI did not influence surgical outcomes of laparoscopic distal gastrectomy after accumulation of surgical experience.
本研究旨在评估手术经验对高体重指数（BMI）患者腹腔镜远端胃切除术的影响。收集了2002年7月至2014年12月期间接受腹腔镜远端胃切除术治疗早期胃癌患者的回顾性数据。患者被分为高BMI组（BMI≥25kg/m）和低BMI组（BMI<25kg/m），并根据外科医生的经验分为亚组。分析并比较了各组之间的患者特征和手术结果。高BMI组的平均手术时间长于低BMI组（173.0±52.5对164.2±48.0分钟；P=0.009）。亚组分析显示，在早期外科医生经验阶段，高BMI组的手术时间长于低BMI组（200.8±49.3对187.9±45.2分钟；P<0.001），且获取的淋巴结较少（36.3±11.7对33.0±13.1；P=0.004）。在后期经验阶段，高BMI组和低BMI组患者的手术结果无显著差异。积累手术经验后，高BMI并不影响腹腔镜远端胃切除术的手术结果。
