Sahakyan Mushegh A, Shahbazyan Sevak S, Martirosyan Aram, Gabrielyan Artak, Petrosyan Hmayak, Sahakyan Artur M
From the *Department of Surgery N1, Yerevan State Medical University After M.Heratsi, Yerevan, Armenia.
†Department of General and Laparoscopic Surgery, Central Clinical Military Hospital, Yerevan, Armenia.
Am Surg. 2020 Feb 1;86(2):158-163.
Obesity is a major health issue in the modern world population and a risk factor for surgical procedures. This study examined perioperative and oncologic results of gastrectomy in obese patients diagnosed with gastric cancer. BMI ≥30 kg/m² was used to designate obesity. Five hundred and one patients were operated throughout the study period (2009-2018). The outcomes in obese patients (n = 205) were compared with those with normal weight (n = 171) and overweight (n = 125). The mean BMI was significantly different between the groups: 21.9 26.7 33.3 kg/m² ( < 0.01), respectively. Obesity was associated with higher incidence of comorbidities, longer operative time, and increased blood loss. Postoperative and short-term oncologic outcomes were similar. Median follow-up was 24 months with similar recurrence rates in the three groups. Median survival was comparable between the normal weight, overweight, and obese patients-36 (27-45) 42 (30-53) 32 (17-47) months, respectively ( = 0.63). Obesity itself does not deteriorate the surgical outcomes of gastrectomy in patients with gastric cancer. Although technically demanding in obese patients, adequate lymph node yield and satisfactory long-term oncologic outcomes can be achieved in this group.
肥胖是现代世界人口中的一个主要健康问题,也是外科手术的一个风险因素。本研究调查了诊断为胃癌的肥胖患者接受胃切除术后的围手术期及肿瘤学结果。体重指数(BMI)≥30kg/m²被用来定义肥胖。在整个研究期间(2009 - 2018年),共有501例患者接受了手术。将肥胖患者(n = 205)的结果与正常体重患者(n = 171)和超重患者(n = 125)的结果进行比较。各组之间的平均BMI有显著差异:分别为21.9、26.7、33.3kg/m²(P < 0.01)。肥胖与更高的合并症发生率、更长的手术时间及更多的失血量相关。术后及短期肿瘤学结果相似。中位随访时间为24个月,三组的复发率相似。正常体重、超重和肥胖患者的中位生存期相当,分别为36(27 - 45)、42(30 - 53)、32(17 - 47)个月(P = 0.63)。肥胖本身并不会使胃癌患者胃切除术后的手术结果恶化。尽管肥胖患者的手术技术要求较高,但该组患者仍可实现足够的淋巴结清扫数量及令人满意的长期肿瘤学结果。