Does overweight affect outcomes in patients undergoing gastrectomy for cancer? A meta-analysis of 25 cohort studies

Overweight was regarded as one of the risk factors for poor outcome after gastrectomy, but its influence on the surgical and postoperative outcomes of gastrectomy was unclear.

Comprehensive searches were conducted to include cohort studies which evaluated the influence of overweight on the surgical and postoperative outcomes of gastrectomy. Data was analyzed by RevMan 5.0.

Twenty-five cohort studies (18 518 patients) were included. Overweight patients were associated with longer operation time (mean difference 20.88, 95% confidence interval 14.07, 27.69), more intraoperative blood loss (mean difference 35.45, 95% confidence interval 9.24, 61.67), and less retrieved lymph nodes (mean difference -2.17, 95% confidence interval -3.51, -0.83) than normal patients undergoing laparoscopy-assisted gastrectomy. And overweight patients were associated with longer operation time (mean difference 26.31, 95% confidence interval 21.92, 30.70), more intraoperative blood loss (mean difference 130.02, 95% confidence interval 75.49, 184.55), less retrieved lymph nodes (mean difference -3.18, 95% confidence interval -4.74, -1.61), longer postoperative hospital stay (mean difference 2.37, 95% confidence interval 0.03, 4.70) and more postoperative complications (risk ratio 1.53, 95% confidence interval 1.29, 1.80) than normal patients in open gastrectomy.

Overweight might affect the clinical results of both laparoscopy-assisted and open gastrectomy, especially for open gastrectomy.