Body mass index, fat volume and outcome of laparoscopy-assisted distal gastrectomy

We evaluated the relationship between body mass index (BMI), CT-estimated fat volume, operation time, and blood loss in laparoscopy-assisted distal gastrectomy (LADG) for carcinoma. Subjects were 16 patients undergoing LADG for early gastric cancer (cT1N0M0) in the lower or middle-third stomach, between March 2007 and February 2008, in our hospital. No major complications occurred. Correlations were seen between BMI and operation time, and BMI and blood loss. We measured intra-abdominal fat volume at the umbilicus level using abdominal CT. Correlations between fat volume and operation time, and fat volume and blood loss, were greater than those of BMI. The operation part times during surgical procedures were measured in all cases. Among them, greater variance was observed in lymph node No.4d, 6 dissection and lymph node No.7, 8a, 9 dissection procedure. Correlations between these operation part times and fat volume were also observed. Obesity lengthened operation time and increased blood loss in LADG. Fat volume measured by CT indicated the effect of obesity on operation more clearly than BMI. (author)