Effect of Obesity on Surgical Outcomes and Survival for Gastric Cancer

Inclusion Criteria:

1. Preoperative endoscopy and biopsy confirmed gastric adenocarcinoma, and predictively feasible of conventional open total gastrectomy or subtotal gastrectomy;
2. Predictively resectable diseases, of preoperative staging Japanese Gastric Cancer Association 14th Edition clinical T1N0M0-T4aN+M0;
3. Age：≤75 years, or ≥18 years;
4. Without serious disease and malignance disease;
5. Without histories of abdominal surgery;
6. World Health Organization performance score ≤2, American Society of Anesthesiologists score ≤3;
7. No limit to sexual and race;
8. Informed consent required;
9. Obesity is defined as BMI≧30kg/m2 or preoperative AFA≧100cm2/cm.

Exclusion Criteria:

1. Patients with other severe complications cannot tolerate surgery: such as severe heart and lung diseases, heart function below clinical stage 2, uncontrollable hypertension, pulmonary infection, moderate to severe chronic obstructive pulmonary disease, chronic bronchitis, severe diabetes and / or renal insufficiency, severe hepatitis and / or function below the rank of CHILD B grade, and severe malnutrition, etc;
2. Patients treated with neoadjuvant chemotherapy or radiation therapy which might affect the efficacy observation;
3. Severity mental diseases;
4. Primary lesion cannot be resected in the pattern of transabdominal gastrectomy, but for Whipple's procedure, or with a transthoracic approach surgery;
5. After signature the Clinical trial agreement, patients and their agent will quit the trial.