Comparison of surgical outcomes of left anterior approach versus left posterior approach in laparoscopic distal gastrectomy for gastric cancer among patients with different BMI
CUI Shijian
FAN Ling
LI Changrui
CHEN Junming
LI Xin
YE Haijun
Abstract：Objective To compare the surgical outcomes and safety of the left anterior approach versus the left poste-rior approach in laparoscopic distal gastrectomy for gastric cancer among patients with different body mass index(BMI).Methods A retrospective analysis was conducted on 164 patients undergoing laparoscopic distal gastrectomy.Patients were stratified into the normal-weight group(BMI<25 kg/m2,n=87)and the overweight group(BMI≥25 kg/m2,n=77).Each group was further divided into left anterior approach(normal-weight:45 cases;overweight:37 cases)and left poste-rior approach subgroups(normal-weight:42 cases;overweight:40 cases).Clinical characteristics and perioperative out-comes were compared,including operative time,the number of lymph nodes harvested,hospital stay,postoperative serum albumin,hemoglobin levels,and complication rates on day one.Results In the normal-weight group,the anterior ap-proach group had a shorter operative time than the posterior approach group(P<0.05).No significant differences were ob-served in lymph node yield,postoperative serum albumin,hemoglobin levels,or complication rates(all P>0.05).In the overweight group,the anterior approach group demonstrated a shorter operative time(P<0.05)and a higher lymph node yield(P<0.05);no significant differences were found in the postoperative serum albumin,hemoglobin levels,and compli-cation rates between these two groups(all P>0.05).The incidence of postoperative complications in the normal-weight group was 6.7%(3/45)for patients in the left anterior approach subgroup and 11.9%(5/42)for those in the left posteri-or approach subgroup,with no significant difference(P>0.05).In the overweight group,the incidence of postoperative complications was 10.8%(4/37)for patients in the left anterior approach subgroup and 17.5%(7/40)for those in the left posterior approach subgroup,with no significant difference(P>0.05).Conclusions Both the left anterior approach and the left posterior approach were safe and feasible in laparoscopic distal gastrectomy for patients with different BMI lev-els.However,the left anterior approach had a higher surgical efficiency,and for overweight patients,the left anterior ap-proach provided more thorough lymph node dissection.
Keywords：body mass indexlaparoscopic distal gastrectomy for gastric cancersurgical approachleft anterior approachleft posterior approach
Publication Date：2025-10-25
Online Publishing Date：2025-11-20(First online date of this platform, not the publication date of the document)
Pages：5( 58-62 )