Impact of body mass index on surgical outcomes in radical total gastrectomy

Background/Aims: In this study, the authors evaluated the impact of body mass index (BMI) on surgical outcomes in patients undergoing total gastrectomy for upper third early gastric cancer. Methodology: Sixty-one consecutive patients with upper third early gastric cancer that underwent radical total gastrectomy from May 2009 to December 2009 were included in this prospective cohort study. Patients were stratified by BMI (in accordance with the WHO guidelines) into a normal group (18.5-24.9kg/m ²), and an over-weight group (≥25.0kg/m ²). These two groups were compared with respect to stomach specimen weight (g), operative time (min), number of lymph nodes harvested, length of postoperative hospital stay (day), and postoperative complication rate (%). Results: Thirty-seven (61%) patients had a normal weight and 24 (39%) were overweight. According to multivariate analysis, the only factor correlated with BMI was the weight of stomach extirpated en bloc with omentum, and the weight of stomach extirpated en bloc with omentum was also significantly correlated with operative time. However, BMI was not found to be significantly correlated with postoperative complications. Conclusions: This study suggested that an elevated BMI was significantly associated with increased weight of stomach extirpated en bloc with omentum, which was found to elongate operative times.