Kang Dong Yeon, Kim Ho Goon, Kim Dong Yi
Division of Gastroenterologic Surgery, Department of General Surgery, Chonnam National University Hospital, Gwang-ju, South Korea.
PLoS One. 2021 Aug 5;16(8):e0255855. doi: 10.1371/journal.pone.0255855. eCollection 2021.
Reduced-port laparoscopic gastrectomy is currently widely performed for patients with gastric cancer. However, its safety in obese patients has not yet been verified. This is the first study on reduced-port laparoscopic distal gastrectomy (RpLDG) in obese patients with gastric cancer. This study aimed to evaluate the short-term surgical outcomes and investigate the feasibility and safety of RpLDG in obese patients with gastric carcinoma.
A total of 271 gastric cancer patients who underwent RpLDG at our institution were divided into two groups: non-obese [body mass index (BMI) <30 kg/m2, n = 251; NOG] and obese (BMI ≥30 kg/m2, n = 20; OG). The mean age of the enrolled patients was 64.8 ± 11.4 years, with 72.0% being men and 28.0% women. Operative details and short-term surgical outcomes, including hospital course and postoperative complications, were compared by retrospectively reviewing the medical records.
No significant difference in operation time was found between the NOG and OG (205.9 ± 40.0 vs. 211.3 ± 37.3 minutes, P = 0.563). Other operative outcomes in the OG, including estimated blood loss (54.1 ± 86.1 vs. 54.0 ± 39.0 mL, P = 0.995) and retrieved lymph nodes (36.2 ± 16.4 vs. 35.5 ± 18.2, P = 0.875), were not inferior to those in the NOG. There were also no statistical differences in short-term surgical outcomes, including the incidence of surgical complications (13.9% vs. 10.0%, P = 1).
RpLDG can be performed safely in obese gastric cancer patients by an experienced surgeon. It should be considered a feasible alternative to conventional port distal gastrectomy.
目前，减孔腹腔镜胃切除术在胃癌患者中广泛开展。然而，其在肥胖患者中的安全性尚未得到证实。这是第一项关于肥胖胃癌患者的减孔腹腔镜远端胃切除术（RpLDG）的研究。本研究旨在评估肥胖胃癌患者行RpLDG的短期手术效果，并探讨其可行性和安全性。
在我们机构接受RpLDG的271例胃癌患者被分为两组：非肥胖组[体重指数（BMI）<30 kg/m²，n = 251；非肥胖组（NOG）]和肥胖组（BMI≥30 kg/m²，n = 20；肥胖组（OG）]。纳入患者的平均年龄为64.8±11.4岁，男性占72.0%，女性占28.0%。通过回顾病历，比较手术细节和短期手术效果，包括住院过程和术后并发症。
非肥胖组和肥胖组的手术时间无显著差异（205.9±40.0 vs. 211.3±37.3分钟，P = 0.563）。肥胖组的其他手术结果，包括估计失血量（54.1±86.1 vs. 54.0±39.0 mL，P = 0.995）和获取的淋巴结数量（36.2±16.4 vs. 35.5±18.2，P = 0.875），并不低于非肥胖组。短期手术效果，包括手术并发症的发生率（13.9% vs. 10.0%，P = 1），也没有统计学差异。
经验丰富的外科医生可以在肥胖胃癌患者中安全地实施RpLDG。它应被视为传统多孔远端胃切除术的一种可行替代方案。
