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KMID : 0914820150150030151
Journal of the Korean Gastric Cancer Association
2015 Volume.15 No. 3 p.151 ~ p.158
Is There any Role of Visceral Fat Area for Predicting Difficulty of Laparoscopic Gastrectomy for Gastric Cancer?
Shin Ho-Jung

Son Sang-Yong
Long-Hai Cui
Byun Cheul-Su
Hur Hoon
Lee Jei-Hee
Kim Young-Chul
Han Sang-Uk
Cho Yong-Kwan
Abstract
Purpose: Obesity is associated with morbidity following gastric cancer surgery, but whether obesity influences morbidity after laparoscopic gastrectomy (LG) remains controversial. The present study evaluated whether body mass index (BMI) and visceral fat area (VFA) predict postoperative complications.

Materials and Methods: A total of 217 consecutive patients who had undergone LG for gastric cancer between May 2003 and December 2005 were included in the present study. We divided the patients into two groups (¡®before learning curve¡¯ and ¡®after learning curve¡¯) based on the learning curve effect of the surgeon. Each of these groups was sub-classified according to BMI (<25 kg/m2 and ¡Ã25 kg/m2) and VFA (<100 cm2 and ¡Ã100 cm2). Surgical outcomes, including operative time, quantity of blood loss, and postoperative complications, were compared between BMI and VFA subgroups.

Results: The mean operative time, length of hospital stay, and complication rate were significantly higher in the before learning curve group than in the after learning curve group. In the subgroup analysis, complication rate and length of hospital stay did not differ according to BMI or VFA; however, for the before learning curve group, mean operative time and blood loss were significantly higher in the high VFA subgroup than in the low VFA subgroup (P=0.047 and P=0.028, respectively).

Conclusions: VFA may be a better predictive marker than BMI for selecting candidates for LG, which may help to get a better surgical outcome for inexperienced surgeons.
KEYWORD
Stomach neoplasms, Laparoscopic, Gastrectomy, Obesity, Intra-abdominal fat
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