Seung Soo Lee, Seung Wan Ryu, In Ho Kim , Soo Sang Sohn

Background  Although surgeons may expect difficulties in performing gastrectomy on patients with high body mass index (BMI), it is not always the case, especially regarding patient gender. The aim of this study was to evaluate gender as a predictive factor of surgical outcomes related to obesity, as defined by the World Health Organization for the Asia-Pacific region.
Methods  Data of short-term surgical outcomes were obtained from 243 patients following open curative distal subtotal gastrectomy for gastric adenocarcinoma. Patients were classified into two groups by gender, and were further classified by BMI into group A (BMI ≥25 kg/m2) and group B (BMI <25 kg/m2). The operation time, extent of surgical bleeding, the number of resected lymph nodes, postoperative hospital stay, serum amylase levels, white blood cell count and postoperative complications were accessed for each group.
Results  Within male patients, the operation time tended to be longer in group A, albeit without statistical significance (P=0.075). However, the extent of surgical bleeding was significantly larger in group A (P=0.002). Within female patients, there were no such differences. When comparisons were made between male and female patients in group A, the operation time was significantly longer in male patients (P=0.019). The extent of bleeding tended to be larger in males, albeit without statistical significance (P=0.065). No such differences were seen when comparisons were made between male and female patients in group B.
Conclusions  Disparity in surgical outcomes between male and female patients does exist, particularly in patients with high BMI. Gender adjustment of BMI must be performed when predicting surgical outcomes.