KMID : 0371420231040010018
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Annals of Surgical Treatment and Research 2023 Volume.104 No. 1 p.18 ~ p.26
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Comparison between laparoscopic pylorus-preserving gastrectomy and laparoscopic distal gastrectomy for overweight patients with early gastric cancer
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Lee Hwa-Jeong
Kim Sa-Rah Park Ji-Hyun Suh Yun-Suhk Park Do-Joong Lee Hyuk-Joon Yang Han-Kwang Kong Seong-Ho Alzahrani Khalid Mohammed
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Abstract
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Purpose : Laparoscopic pylorus-preserving gastrectomy (LPPG) has a nutritional advantage over laparoscopic distal gastrectomy (LDG), however, may be less beneficial in overweight patients in terms of weight loss. The purpose of this study was to compare LPPG and LDG in overweight patients with early gastric cancer.
Methods : Clinicopathologic data of overweight patients (body mass index [BMI], ¡Ã25 kg/m2) who underwent LPPG (n = 63) or LDG (n = 183) in 2016?2018 were retrospectively reviewed. In the LDG group, patients with Billroth-II anastomosis were separately grouped (LDG B-II, n = 66). Changes in BMI, hemoglobin, albumin, and total protein were compared among groups.
Results : Changes in BMI were not significant different among groups. The LPPG group had significantly higher albumin than the LDG group at postoperative 6 months and 1 year. The LPPG group had higher total protein than the LDG group at postoperative 2 years. The LPPG group had a higher complication rate of Clavien-Dindo classification III or higher (20.6%) than the LDG group (8.2%, P = 0.007). However, after excluding pyloric stenosis, there was no significant difference among groups (LPPG vs. LDG, P = 0.290; LPPG vs. LDG B-II, P = 0.921).
Conclusion : LPPG and LDG groups showed similar weight loss. However, the LPPG group had higher albumin and protein levels than the LDG group of overweight patients. Thus, it is not necessary to select LDG only for weight loss. LPPG may be selected as one option due to its potential nutritional benefit when pyloric stenosis is properly managed.
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KEYWORD
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Gastrectomy, Overweight, Stomach neoplasms
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