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Comparative Study
. 2025 Sep;77(5):1637-1643.
doi: 10.1007/s13304-025-02144-x. Epub 2025 May 3.

Short-term outcomes of minimally invasive gastrectomy in population with obesity versus population without obesity: the obesity paradox

Marco Milone  1 , Anna D'Amore  2 , Gian Luca Baiocchi  3 , Fabio Cianchi  4 , Giovanni De Manzoni  5 , Stefano De Pascale  6 , Maurizio Degiuli  7 , Giorgio Ercolani  8 , Giovanni Ferrari  9 , Laura Fortuna  4 , Romario Uberto Fumagalli  6 , Monica Gualtierotti  9 , Federico Marchesi  10 , Andrea Peri  11 , Francesco Puccetti  12 , Marco Realis Luc  6 , Rossella Reddavid  7 , Riccardo Rosati  12 , Leonardo Solaini  8 , Fabio Staderini  4 , Marina Valente  10 , Jacopo Viganò  11 , Ugo Elmore  12 , Simone Giacopuzzi  5
Affiliations
Comparative Study

Short-term outcomes of minimally invasive gastrectomy in population with obesity versus population without obesity: the obesity paradox

Marco Milone et al. Updates Surg. 2025 Sep.

Abstract

This study aims to compare the short-term outcomes after minimally invasive gastrectomy between obese and non-obese population. Our analysis included data of 713 patients from ten departments of surgery. They were divided in non-obese group and obese group with 617 and 96 patients respectively. Significant differences were found in terms of mortality at 90 days (obese: 0 vs non-obese: 27, p = 0.037). Intraoperative data showed no significant differences in terms of conversion (obese: 4 vs non-obese: 43, p = 0.303). About postoperative complications, significant differences between the two groups were found only in terms of surgical infection (obese: 13 vs non-obese: 38, p = 0.009). About oncological outcomes, no differences were found about retrieved lymph nodes (obese: 30.71 ± 18.44 vs non-obese: 32.93 ± 17.62, p = 0.596) and about surgical radicality (R0) (obese:94 vs non-obese:594, p = 0.415). Obesity doesn't worsen postoperative outcomes and minimally invasive gastrectomy in obese patients is related to a lower postoperative mortality.

Keywords: Gastrectomy; Gastric cancer; Minimally invasive surgery; Obesity; Paradox.

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Conflict of interest statement

Declarations. Conflicts of interest: The authors declare no conflict of interest. Institutional review board: This study was conducted according to the guidelines of the 1975 Declaration of Helsinki.

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