Yuki Yokota, Masashi Hirota, Hirotsugu Nagase, Tomono Kawase, Hiroshi Imamura, Kozo Noguchi, Atsushi Hamabe, Kazuteru Oshima, Tsukasa Tanida, Yoshito Tomimaru, Shunji Morita, Takashi Iwazawa, Kenzo Akagi, Keizo Dono. Department of Surgery, Toyonaka Municipal Hospital, Japan
INTRODUCTION: The loss of body weight and body skeletal muscle mass after gastrectomy is associated with worse quality of life and decreased survival in gastric cancer patients. Maintaining body weight and skeletal muscle mass after gastrectomy may lead to improved outcomes. The aim of this study was to evaluate the longitudinal changes in body weight and body composition (skeletal muscle mass and adipose tissue mass) after conventional open gastrectomy (OG) and laparoscopic assisted gastrectomy (LG) for early gastric cancer.
METHODS: Seventy-two patients, who underwent distal gastrectomy and were diagnosed with pathologically Stage I gastric cancer, were retrospectively analyzed (41 patients for OG, 31 patients for LG). We evaluated body composition with the parameters based on measurement of cross sectional area of psoas muscle and adipose tissue from abdominal computed tomography. These parameters and body weight were obtained preoperatively and at 6 and 12 months postoperatively and we compared the changes between the two groups (OG vs. LG). Univariate and multivariate logistic regression analyses was also conducted to identify clinical factors contributing significant loss of skeletal muscle mass.
RESULTS: There were no difference between the two groups in patients’ backgrounds except that in the OG group, Roux-en-Y reconstruction was more commonly selected, amount of intraoperative blood loss was greater and operative duration was longer. There were no significant difference between the two groups in the degree of decrease in each parameters at 6 months after operation, while, at 12 months after operation, OG group showed significantly greater decrease than LG group in any parameters: % of the preoperative value (OG vs. LG) were 91.6 vs. 94.4 (p=0.0485) in body weight, 91.5 vs. 94.9 (p=0.0408) in skeletal muscle and 58.7 vs. 71.9 (p=0.0343) in adipose tissue. Open gastrectomy (hazard ratio 4.83, 95% confidence interval, 1.097-34.482) was identified as the single independent risk factor for more than 15% loss of skeletal muscle mass at 12 months after operation.
CONCLUSION: Laparoscopic gastrectomy might have some advantage in maintenance of body weight and body composition during the first postoperative year over the conventional open approach.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79943
Program Number: P643
Presentation Session: Poster (Non CME)
Presentation Type: Poster