Laparoscopic gastrectomy in obese patients with gastric cancer

The aim of this study was to assess the surgical and survival outcomes of laparoscopic gastrectomy in obese patients with gastric cancer.

All obese patients (body mass index/BMI ≥30 kg/m²) who underwent laparoscopic gastrectomy for gastric cancer with radical intent from January 2008 to September 2016 were compared with non-obese patients undergoing similar surgery. The patient short- and long-term outcomes (overall [OS] and disease-free survival [DFS]) were reviewed.

Fifty-seven obese and 153 non-obese patients underwent laparoscopic gastrectomy for gastric cancer. Operating times were not significantly different. The conversion rate was higher in obese patients than in non-obese patients. Postoperative 30-day morbidity was greater in obese patients than in non-obese patients. The duration of postoperative hospital stay was similar for laparoscopically completed cases (9 days for obese patients vs 8 days for non-obese patients), but in the obese-converted group it was 13 days. Pathological data were equivalent between obese and non-obese patients. The 5-year OS and DFS was similar between the two groups.

Laparoscopic gastrectomy for gastric cancer in obese patients is technically feasible and oncologically safe. However, a higher postoperative 30-day morbidity and conversion rate was observed in obese patients.