Impact of body mass index on short-term outcomes of laparoscopic gastrectomy in Asian patients: A meta-analysis

Heng-Kai Chen; Guang-Wei Zhu; Yong-Jian Huang; Wei Zheng; Shu-Gang Yang; Jian-Xin Ye

doi:10.12998/wjcc.v6.i15.985

Impact of body mass index on short-term outcomes of laparoscopic gastrectomy in Asian patients: A meta-analysis

World J Clin Cases. 2018 Dec 6;6(15):985-994. doi: 10.12998/wjcc.v6.i15.985.

Authors

Heng-Kai Chen¹, Guang-Wei Zhu¹, Yong-Jian Huang¹, Wei Zheng¹, Shu-Gang Yang¹, Jian-Xin Ye¹

Affiliation

¹ Department of Gastrointestinal Surgery 2 Section, the First Hospital Affiliated to Fujian Medical University, Fuzhou 350005, Fujian Province, China.

Abstract

Aim: To perform a meta-analysis to investigate the correlation between body mass index (BMI) and the short-term outcomes of laparoscopic gastrectomy (LG) for gastric cancer (GC) in Asian patients.

Methods: The PubMed, Cochrane, EMBASE, and Web of Science databases were searched for studies that focused on the impact of obesity on the short-term outcomes of LG for GC in Asian patients who were classified into a high BMI (BMI ≥ 25 kg/m²) or low BMI group (BMI < 25 kg/m²). The results are expressed using the pooled odds ratio (OR) for binary variables and standard mean difference (SMD) for continuous variables with 95% confidence interval (CI), and were calculated according to the fixed-effects model while heterogeneity was not apparent or a random-effects model while heterogeneity was apparent.

Results: Nine studies, with a total sample size of 6077, were included in this meta-analysis. Compared with the low BMI group, the high BMI group had longer operative time (SMD = 0.26, 95%CI: 0.21 to 0.32, P < 0.001), greater blood loss (SMD = 0.19, 95%CI: 0.12 to 0.25, P < 0.001), and fewer retrieved lymph nodes (SMD = -0.13, 95%CI: 0.18 to 0.07, P < 0.001). There was no significant difference between the high and low BMI groups in postoperative complications (OR = 1.12, 95%CI: 0.95 to 1.33, P = 0.169), the duration of postoperative hospital stay (SMD = 0.681, 95%CI: -0.05 to 0.07, P = 0.681), postoperative mortality (OR = 1.95, 95%CI: 0.78 to 4.89, P = 0.153), or time to resuming food intake (SMD = 0.00, 95%CI: -0.06 to 0.06, P = 0.973).

Conclusion: Our meta-analysis provides strong evidence that despite being associated with longer operative time, greater blood loss, and fewer retrieved lymph nodes, BMI has no significant impact on the short-term outcomes of LG for GC in Asian patients, including postoperative complications, the duration of postoperative hospital stay, postoperative mortality, and time to resuming food intake. BMI may be a poor risk factor for short-term outcomes of LG. Other indices should be taken into account.

Keywords: Body mass index; Gastric cancer; Laparoscopic gastrectomy; Meta-analysis; Obesity.