내장지방영역이 복강경 위암 수술의 난이도를 예측하는데 도움이 되는가?

Purpose: Obesity is known to be associated with postoperative morbidity in gastric cancer surgery, but its impact on laparoscopic gastrectomy (LG) remains controversial. In present study, we evaluate the obesity parameters including body mass index (BMI) and abdominal fat area as a predictive factors for postoperative complications. Materials and methods: A total of 217 patients who underwent consecutive LG for gastric cancer between May 2003 and December 2005 were reviewed for the present study. We divided the patients into two groups by 50th case based on the learning curve effect, and then each group was subclassified by 25kg/m2 of BMI and 100cm2 of VFA. The surgical outcomes including operative time, blood loss and postoperative complications were compared according to BMI and VFA. Results: The mean operative time, the length of hospital stays, and complication rate were significantly higher in before 50th case group. In subgroup analysis, complication rate and the length of hospital stays did not differ in high BMI or VFA subgroups compared with lower BMI or VFA subgroups. However, in before 50th case group, the mean operative time and blood loss were significantly higher in high VFA subgroup (p=0.047 and p=0.028, respectively). Conclusion: To minimize the surgical complication in inexperienced surgeon, VFA can be a better predictive marker than BMI for selecting candidates of laparoscopic gastrectomy.Ⅰ. INTRODUCTION 1 Ⅱ. MATERIALS AND METHODS 3 A. Patients 3 B. Estimation of body fat compartments 3 C. Surgical technique 4 D. Statistical Analysis 4 Ⅲ. RESULTS 5 A. Patients’ Characteristics 5 B. Correlation between body mass index and body fat compartments 5 C. Subgroup analysis according to body mass index and visceral fat area 5 D. Overall survival according to obesity status and surgeon experience 6 Ⅳ. DISCUSSION 7 REFERENCES 9 LIST OF FIGURES 12 LIST OF TABLES 14Maste