The Shortest Distance from the Skin to Pancreas and the Lower Sternum Angle can Influence Short-Term Surgical Outcomes of Laparoscopy-Assisted Distal Gastrectomy for Gastric Cancer

The Shortest Distance from the Skin to Pancreas and the Lower Sternum Angle can Influence Short-Term Surgical Outcomes of Laparoscopy-Assisted Distal Gastrectomy for Gastric Cancer | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Help Center Sign In Submit a Preprint Cite Share Download PDF Research The Shortest Distance from the Skin to Pancreas and the Lower Sternum Angle can Influence Short-Term Surgical Outcomes of Laparoscopy-Assisted Distal Gastrectomy for Gastric Cancer Dong Peng, Wei Tao, Yuxi Cheng, Ying-Ying Zou, Kun Qian, Wei Zhang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-84004/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background The surgery of laparoscopic distal gastrectomy + D2 lymph node dissection (LADG) is widely used in patients with gastric cancer, the purpose of the study is to explore the effect of abdominal shape on short-term surgical outcomes. Methods This was a retrospective study which included 316 patients undergoing LADG from January 2013 to June 2019 at a single clinical center. The abdominal parameters including the shortest distance of the pancreas from the anterior abdominal skin (PAAD), the lower sternum angle (LSA), the thickness of subcutaneous fat at the navel level (SFT), the anteroposterior diameters (APD) and left-right diameters(LRD) at the navel level, the distance from xiphoid process to the navel (XND), and the distance from xiphoid process to the pubis (XBD) were calculated by preoperative abdominal computed tomography (CT) image. The parameters and short-term surgical outcomes were analyzed. Results In males, the number of retrieved lymph nodes was significantly higher in patients with BMI <25kg/m2 (p=0.023) and APD <176.2mm (p=0.004). The time of operation was significantly shorter in male patients with BMI <25kg/m2(p=0.001), PAAD <64.6mm(p=0.000), SFT <14.9mm(p=0.017), APD <176.2mm(p=0.002) and LRD 370.0mm(p=0.042). The estimated blood loss was significantly lower in male patients with LSA <83.8° (p=0.009), PAAD <64.6mm(p=0.001), SFT <14.9mm(p=0.001), APD <176.2mm(p=0.009) and LRD <290.0mm(p=0.011). The complications were fewer in male patients with PAAD <64.6mm(p=0.045) and APD <176.2mm(p=0.011), and in female patients with LRD <288.5mm(p=0.047). Conclusion Various abdominal shapes can influence the difficulty of LADG. Lower LSA and PAAD can reduce the difficulty of LADG in male patients. Gastrointestinal Surgery Oncology Abdominal shape Gastric cancer Laparoscopy-assisted distal gastrectomy Short-term surgical outcome Figures Figure 1 Figure 2 Introduction Gastric cancer is one of the most common malignant tumors in the world, ranking fifth among all tumor incidences [ 1 ]. The incidence of gastric cancer in eastern countries is much higher than that in the west, especially in China, Japan, and South Korea [ 2 – 3 ]. The surgery of laparoscopic distal gastrectomy + D2 lymph node dissection (LADG) has been widely used since its first introduction [ 4 ], and the laparoscopic surgical method is widely accepted because of cosmetics and less invasive than open surgical methods [ 5 ]. There are many factors which can affect laparoscopic surgery. Obesity has always been considered as a factor that can not be ignored. Obesity may lead to a decrease in the number of retrieved lymph node, prolong hospital stay, and poor prognosis [ 6 – 8 ]. In addition to obesity, abdominal shape is also considered to be one of the factors that may affect laparoscopic surgery. At present, there is no certain standard for the measurement of abdominal shape. Most studies have focused on the measurement at the navel level, including the thickness of subcutaneous fat, the anteroposterior diameters and left-right diameters, and the area of ​​visceral fat [ 9 – 11 ]. It was found that different abdominal shapes may affect short-term surgical outcomes of LADG. Furthermore, abdominal shape is not only a structure at the navel level, but also a three-dimensional structure from xiphoid process to pubis. Therefore, parameters of other levels are needed. This study focused on some simple abdominal shape parameters and explored the effect on short-term surgical outcomes. Materials And Methods Patients A retrospective research of gastric cancer patients who underwent LADG from January 2013 to June 2019 at a single clinical center was conducted in this study. Ethical approval from the Institutional Review Board was obtained. Patients were included by criteria as follows: 1, Patients who had undergone LADG successfully; and 2, Pathologically confirmed as gastric cancer. Totally, 418 patients were included according to the criteria. Patients were excluded by criteria as follows: 1, Neoadjuvant chemotherapy before surgery (n = 12); 2, Incomplete preoperative abdominal computed tomography (CT) image data (n = 75); 3, Absence of medical records (n = 11); and 4, palliative surgery (n = 4). A total of 316 patients were included in this study. Surgery All patients included in this study underwent LADG, and they were operated by two surgeons with more than 10 years of surgical experience in a same team. The surgical methods were all standard LADG, and the scope of lymph node dissection conformed to the guidelines for laparoscopic surgery of the Chinese Society of Gastric Cancer [ 12 ]. Medical records collections Clinical data were collected from the medical record database. The baseline information included gender, age, BMI, TNM stage (according to the UICC tumor lymph node metastasis classification system definition). The surgical information included operation time, estimated blood loss, postoperative hospital stay, the number of retrieved lymph nodes. The postoperative short-term complications included anastomotic leakage, intra-abdominal abscess, pneumonia, anastomotic bleeding, wound bleeding, wound infection, deterioration of liver function, chyle leakage, stenosis, heart disease, gastroparesis, pulmonary embolism, bowel obstruction, cerebral infarction, urinary tract infection, biliary fistula and death within 30 days after surgery according to Clavien-Dindo classification [ 13 ]. CT Image Data All patients underwent abdomen CT examination within 14 days before the operation. The following parameters of equipment were adopted: the tube current was 150 mA; the tube voltage was 120 kVp; the section thickness was 5 mm; and the section interval was 5 mm. A 64 multi-detector scanner (LightSpeed VCT; GE Healthcare, Waukesha, WI, USA) was used for CT scanning. The scanning range was from the top of the chest to the bottom of the abdomen. An enhanced image was obtained after intravenous injection of 80–90 mL of nonionic contrast agent (320 mg/mL; iopamidol, Shanghai Braco Sinus Pharmaceutical Co., Ltd., Shanghai, China) at an injection rate of 3.0 mL/s using a 50 mL saline tracker. The contrast agent-enhanced CT images were obtained 35 and 120 s after the injection of the contrast agent in the arterial phase and the equilibrium phase, respectively. CT images were measured by the same physician who was blind to the patient’s clinical characteristics. The parameters included the shortest distance of the pancreas from the anterior abdominal skin (PAAD), the lower sternum angle (LSA), the thickness of subcutaneous fat at the navel level (SFT), the anteroposterior diameters(APD) and left-right diameters(LRD) at the navel level, the distance from xiphoid process to navel (XND), and the distance from xiphoid process to pubis (XBD). The PAAD was composed of the shortest vertical distance between the pancreas and the skin of the anterior abdomen in the CT image. The LSA was a downward opening angle formed by the combination of the rib arches and xiphoid process on both sides. It was the apex angle of the triangle formed by the lowermost part of the sternum and the costal arches on both sides, and it could also be called the upper abdominal angle. The calculation of the LSA: Calculating the distance from the anterior midline to the midclavicular line as A, and then Calculating the distance from the level at the intersection of the midclavicular line and the costal arch to the xiphoid process as B, after that, Using the formula LSA = 2*DEGREES (ATAN (A / B)) to calculate LSA. The relevant data were entered and calculated using Microsoft Excel (2019). At the level of the navel, the distance from the anterior abdomen to the parietal peritoneum was defined as the SFT, the distance from the skin of the navel to the skin of the back was defined as the APD, and abdominal lateral diameter at the level of the anterior spine was the LRD (Fig. 1 ). Statistical Analysis The median and range was used for continuous variables that did not conform to the normal distribution. The χ2 statistics, the Fisher's exact test or the Mann–Whitney U test was used between two groups. The cutoff point of BMI was 25 kg/m2, and the cutoff point of other continuous variables was according to the median. Parameters were selected for univariate and multivariate analysis for detection of independent risk factors for postoperative complications. Correlation between the number of retrieved lymph nodes and the parameters of abdominal shape was analyzed by Pearson’s correlation test. Data were analyzed using SPSS (version 20.0) statistical software. A bilateral p value of < 0.05 was considered statistically significant. Results Clinical characteristics of the patients A total of 316 patients were included in this study, including 253 males and 63 females. The median age was 61 (28–86) years. The median number of retrieved lymph nodes was 22 (6–70). The time of operation was 200.0 (90.0-435.0) minutes. The estimated blood loss was 100.0 (10.0-2000.0) milliliter. The postoperative hospital stay was 10 (4–66) days. The number of pathological stage of IA, IB, IIA, IIB, IIIA, IIIB, IIIC was 81, 37, 30, 53, 60, 41 and 14 (Table 1 ). Table 1 Clinical characteristics of the patients Characteristics No.316 Gender Male Female 253 (80.1%) 63 (19.9%) Age, years (median, range) 61 (28–86) TNM stage I (IA/ IB) 81/37 II (IIA/ IIB) 30/53 III (IIIA/ IIIB/ IIIC) 60/41/14 Retrieved lymph nodes (median, range) 22 (6–70) Operation time, minutes (median, range) 200.0 (90.0-435.0) Estimated blood loss, mL (median, range) 100.0 (10.0-2000.0) Postoperative hospital stay, day (median, range) 10 (4–66) Note: Variables are expressed as the median and range, n (%). Abbreviations: BMI, body mass index; TNM, Tumor Node Metastasis. The parameters of abdominal shape and BMI of patients BMI and seven parameters of abdominal shape were calculated between males and females by median and range. The SFT which was 14.9 (1.0-40.5) mm in males and 21.5 (5.8–143.0) mm in females was significantly different (p = 0.000), and the APD which was 176.2 (126.0-263.0) mm in males and 167.5 (122.2–258.0) mm in females was significantly different as well (p = 0.022). There was no difference between males and females as for other parameters of BMI, LSA, PAAD, LRD, XND and XBD. Therefore, males and females were discussed separately because of the difference of abdominal shape (Table 2 ). Table 2 Body shape and BMI of the patients Parameters All (n = 316) Male (n = 253) Female (n = 63) P value BMI (kg/m 2 ) 22.3(15.0-35.2) 22.5(15.0-34.5) 22.1(17.48–35.16) 0.204 LSA (°) 82.8(43.9–143.0) 83.8(43.9–143.0) 80.6(54.3-140.9) 0.122 PAAD (mm) 65.0(20.0-117.1) 64.6(20.0-107.4) 65.8(30.6-117.1) 0.851 SFT (mm) 16.0(1.0-143.0) 14.9(1.0-40.5) 21.5(5.8–143.0) 0.000* APD (mm) 173.4(122.2–263.0) 176.2(126.0-263.0) 167.5(122.2–258.0) 0.022* LRD (mm) 290.0(206.2-380.8) 290.0(206.2-380.8) 288.5(231.4-359.3) 0.632 XND (mm) 215.0(95.0-340.0) 215.0(95.0-340.0) 210.0(165.0-280.0) 0.966 XBD (mm) 370.0(250.0-525.0) 370.0(255.0-525.0) 370.0(250.0-445.0) 0.344 Note: Variables are expressed as the the median and range, *P-value < 0.05. Abbreviations: BMI, body mass index; LSA, the angle of the lower sternum angle; PAAD, the shortest distance of the pancreas from the anterior abdominal skin; SFT, the thickness of subcutaneous fat at the navel level; APD, the anteroposterior diameters at the navel level; LRD, the left-right diameters at the navel level; XND, the distance from xiphoid process to navel; XBD, the distance from xiphoid process to pubis; Short-term surgical outcomes in patients The cutoff point of BMI was 25 kg/m2, and other parameters were dichotomized according to the median. The parameters were divided into higher and lower groups. Short-term surgical outcomes were compared between higher and lower groups of BMI, LSA, PAAD, SFT, APD, LRD, XND and XBD. In males, the number of retrieved lymph nodes was significantly higher in patients with BMI < 25 kg/m2(p = 0.023) and APD < 176.2 mm(p = 0.004). The time of operation was significantly shorter in male patients with BMI < 25 kg/m2(p = 0.001), PAAD < 64.6 mm(p = 0.000), SFT < 14.9 mm(p = 0.017), APD < 176.2 mm(p = 0.002) and LRD 370.0 mm(p = 0.042). The estimated blood loss was significantly smaller in male patients with LSA < 83.8°(p = 0.009), PAAD < 64.6 mm(p = 0.001), APD < 176.2 mm(p = 0.0092), SFT < 14.9 mm(p = 0.001) and LRD < 290.0 mm(p = 0.011). The time of postoperative hospital stay was significantly shorter in male patients with APD < 176.2 mm(p = 0.033) and PAAD < 65.8 mm(p = 0.021). The complications were lower in male patients with PAAD < 64.6 mm(p = 0.045) and APD < 176.2 mm(p = 0.011), and in female patients with LRD < 288.5 mm(p = 0.047) (Table 3 ) (Table 4 ). Table 3 Short-term surgical outcomes in male patients (n = 253) Parameters Retrieved lymph nodes Operation time (minutes) Estimated blood loss (mL) Postoperative hospital stay (day) Complications BMI (kg/m 2 ) ≥ 25(n = 56) 18.5(6–42) 232.5(110–435) 100(10-1800) 10(6–23) 18 BMI (kg/m 2 ) < 25(n = 197) 22(6–70) 197(90–395) 100(20-2000) 10(4–62) 59 P value 0.023* 0.001* 0.179 0.508 0.753 LSA (°) ≥ 83.8(126) 22(6–43) 205.5(90–435) 100(10-1800) 10(4–62) 44 LSA (°) < 83.8(n = 127) 22(6–70) 200(95–380) 100(20-2000) 10(5–33) 33 P value 0.694 0.180 0.009* 0.317 0.122 PAAD (mm) ≥ 64.6(n = 127) 20(6–45) 225(90–435) 100(10-2000) 10(5–62) 46 PAAD (mm) < 64.6(n = 126) 22(6–70) 190(95–395) 100(20–500) 10(4–50) 31 P value 0.052 0.000* 0.001* 0.302 0.045* SFT (mm) ≥ 14.9 20(6–45) 211.5(90–435) 100(20-1800) 10(5–26) 45 SFT (mm) < 14.9(n = 127) 22(6–70) 195(95–370) 100(10-2000) 10(4–50) 32 P value 0.075 0.017* 0.001* 0.636 0.069 APD (mm) ≥ 176.2(n = 126) 19(6–42) 215(90–435) 100(10-2000) 11(4–62) 48 APD (mm) < 176.2(n = 127) 23(6–70) 190(95–395) 100(20–500) 10(6–50) 29 P value 0.004* 0.002* 0.002* 0.033* 0.011* LRD (mm) ≥ 290.0(n = 127) 20(6–42) 210(98–435) 100(10-2000) 10(4–62) 45 LRD (mm) < 290.0(n = 126) 22(6–70) 195(90–395) 100(20–800) 10(6–50) 32 P value 0.307 0.036* 0.011* 0.399 0.083 XND (mm) ≥ 215.0 20(6–47) 205(90–435) 100(10-1800) 10(4–62) 40 XND (mm) < 215.0(n = 121) 22(6–70) 195(95–348) 100(20-2000) 10(6–29) 37 P value 0.081 0.228 0.157 0.858 0.962 XBD (mm) ≥ 370.0(n = 135) 20(6–47) 205(90–435) 100(10-1800) 10(4–42) 39 XBD (mm) < 370.0(n = 118) 22(6–70) 196(95–375) 100(20-2000) 10(5–62) 38 P value 0.274 0.266 0.240 0.715 0.568 Note: Variables are expressed as the median and range, *P-value < 0.05. Abbreviations: BMI, body mass index; LSA, the angle of the lower sternum angle; PAAD, the shortest distance of the pancreas from the anterior abdominal skin; SFT, the thickness of subcutaneous fat at the navel level; APD, the anteroposterior diameters at the navel level; LRD, the left-right diameters at the navel level; XND, the distance from xiphoid process to navel; XBD, the distance from xiphoid process to pubis; Table 4 Short-term surgical outcomes in female patients (n = 63) Parameters Retrieved lymph nodes Operation time (minutes) Estimated blood loss (mL) Postoperative hospital stay (day) Complications BMI (kg/m2) ≥ 25(n = 7) 27(11–33) 210(120–315) 50(40–100) 11(7–16) 1 BMI (kg/m2) < 25(n = 56) 23(7–45) 197.5(100–310) 50(10-1000) 8.5(4–66) 11 P value 0.569 0.463 0.351 0.127 1 LSA (°) ≥ 80.6(n = 33) 23(8–40) 205(100–315) 50(20-1000) 9(6–66) 5 LSA (°) < 80.6(n = 30) 24(7–45) 187.5(110–303) 50(10–300) 8.5(4–51) 7 P value 0.710 0.397 0.533 0.323 0.409 PAAD (mm) ≥ 65.8(n = 31) 22(8–45) 200(100–315) 50(20–300) 10(7–66) 6 PAAD (mm) < 65.8(n = 32) 24(7–45) 195(115–310) 50(10-1000) 8(4–51) 6 P value 0.364 0.700 0.524 0.021* 0.951 SFT (mm) ≥ 21.5(n = 31) 22(8–35) 195(110–315) 50(20–300) 10(6–66) 7 SFT (mm) < 21.5(n = 32) 24.5(7–45) 200(100–310) 75(10-1000) 8(4–35) 5 P value 0.141 0.891 0.244 0.158 0.482 APD (mm) ≥ 167.5(n = 31) 22(8–33) 195(100–315) 50(20-1000) 10(7–66) 7 APD (mm) < 167.5(n = 32) 25(7–45) 200(115–303) 75(10–400) 8(4–51) 5 P value 0.107 0.767 0.182 0.249 0.482 LRD (mm) ≥ 288.5(n = 31) 23(7–33) 210(100–315) 50(20–400) 10(4–66) 9 LRD (mm) < 288.5(n = 32) 24(10–45) 178.5(115–310) 50(10-1000) 8(6–51) 3 P value 0.066 0.100 0.930 0.158 0.047* XND (mm) ≥ 210.0(n = 37) 23(7–45) 190(100–310) 50(10-1000) 9(4–66) 9 XND (mm) < 210.0(n = 26) 24.5(8–39) 207.5(130–315) 75(20–400) 8.5(6–53) 3 P value 0.375 0.079 0.246 0.805 0.329 XBD (mm) ≥ 370.0(n = 38) 23.5(8–45) 187.5(100–310) 50(10-1000) 8(6–66) 6 XBD (mm) < 370.0(n = 25) 24(7–39) 210(135–315) 100(20–300) 10(4–53) 6 P value 0.807 0.042* 0.315 0.166 0.521 Note: Variables are expressed as the median and range, *P-value < 0.05. Abbreviations: BMI, body mass index; LSA, the angle of the lower sternum angle; PAAD, the shortest distance of the pancreas from the anterior abdominal skin; SFT, the thickness of subcutaneous fat at the navel level; APD, the anteroposterior diameters at the navel level; LRD, the left-right diameters at the navel level; XND, the distance from xiphoid process to navel; XBD, the distance from xiphoid process to pubis; Predictive factors for postoperative complications Eighty-nine patients had postoperative complications, the highest complication was pneumonia (Table 6 ). Univariate analysis was used for postoperative complications, and it was found that PAAD (p = 0.046, odds ratio = 1.740, 95%CI = 1.011–2.997) and APD (p = 0.011, odds ratio = 2.032, 95%CI = 1.174–3.517) were independent factors for predicting postoperative complications in males. however, in multivariate analysis, PAAD and APD showed no difference in males. In females, there was no difference in univariate and multivariate analysis (Table 5 ). Table 5 Univariate and multivariate analysis of predictive factors for postoperative complications Risk factors Univariate analysis Multivariate analysis Male Female Male P value Odds ratio (95% CI) P value Odds ratio (95% CI) P value Odds ratio (95% CI) BMI (kg/m2) 0.753 1.108 (0.585–2.098) 0.735 0.682 (0.074–6.261) LSA (°) 0.123 1.528 (0.891–2.622) 0.412 0.587 (0.164–2.096) PAAD (mm) 0.046* 1.740 (1.011–2.997) 0.951 1.040 (0.296–3.658) 0.616 1.197 (0.594–2.413) SFT (mm) 0.070 1.649 (0.960–2.835) 0.484 1.575 (0.441–5.623) APD (mm) 0.011* 2.032 (1.174–3.517) 0.484 1.575 (0.441–5.623) 0.097 1.814 (0.897–3.668) LRD (mm) 0.084 1.612 (0.938–2.770) 0.058 3.955 (0.957–16.349) XND (mm) 0.962 0.987 (0.577–1.687) 0.213 2.464 (0.597–10.178) XBD (mm) 0.568 0.855 (0.500-1.462) 0.449 0.613 (0.173–2.177) Note: Variables are dichotomized according to the median, *P-value < 0.05. Abbreviations: BMI, body mass index; LSA, the angle of the lower sternum angle; PAAD, the shortest distance of the pancreas from the anterior abdominal skin; SFT, the thickness of subcutaneous fat at the navel level; APD, the anteroposterior diameters at the navel level; LRD, the left-right diameters at the navel level; XND, the distance from xiphoid process to navel; XBD, the distance from xiphoid process to pubis; OR, odds ratio; CI, confidence interval. Table 6 Postoperative complications Complications All Male Female Anastomotic leakage 18 16 2 Intra-abdominal abscess 7 5 2 Pneumonia 32 31 1 Anastomotic bleeding 5 4 1 Wound bleeding 1 1 0 Wound infection 6 5 1 Deterioration of liver function 1 1 0 Chyle leakage 1 1 0 Stenosis 3 2 1 Heart disease 4 3 1 Gastroparesis 1 1 0 Pulmonary embolism 2 2 0 bowel obstruction 2 1 1 Cerebral infarction 2 1 1 Urinary tract infection 3 2 1 Biliary fistula 1 1 0 Death 0 0 0 Total 89 77 12 Note: Variables are expressed as n. Correlation between abdominal shape parameters and retrieved lymph nodes There was no difference between the number of retrieved lymph nodes and the parameters of abdominal shape in females (p > 0.05). In males, PAAD (p = 0.006, k=-0.172), SFT (p = 0.018, k=-0.149) and APD (p = 0.004, k=-0.183) were correlated with the retrieved lymph nodes (Fig. 2 ). Discussion This study innovatively explored simple index of abdominal shape of PAAD, LSA and other parameters on short-term surgical outcomes in patients undergoing LADG. We found that abdominal shape can influence operation time, estimated blood loss, postoperative hospital stay, the number of retrieved lymph nodes and complications. Furthermore, abdominal body shape differed between two genders, males had larger APD and smaller SFT over females. Therefore, we analyzed males and females separately and found that few abdominal shape parameters had an impact on short-term surgical outcomes in females. However, in males, we found some abdominal shape parameters were crucial. The result was consistent with the previously published literature [ 10 – 11 , 14 ]. Obesity has always been considered an independent factor in patients with gastric cancer. BMI can be a parameter to represent obesity. Some studies believed that BMI has an impact on postoperative complications and survival [ 15 – 16 ]. In this study, males with BMI < 25 had less operation time and larger number of retrieved lymph nodes. It can be seen that obesity has an impact on the difficulty of LADG in male patients. The operation time and estimated blood loss can reflect the difficulty of the operation. Previous studies have found that large APD can increase the operation time and Large LRD can increase the amount of surgical bleeding [ 10 – 11 ]. In this study, larger PAAD, SFT, APD and LRD contributed to increase of operation time in males, and smaller XBD contributed to increase of operation time in females. As for estimated blood loss, patients with larger LSA, PAAD, APD, SFT and LRD could experience larger amount of estimated blood loss in males, but all parameters had negative relationship with females. Different distensibility of abdominal wall in men and women due to accumulation of muscle and lipid may explain why abdominal shape was more strongly associated with male patients than female patients [ 17 ]. The extra operation time and blood loss may be the large size of abdominal shape and excess fat tissues accumulated around vessels [ 11 ]. As for larger LSA resulted in larger amount of estimated blood loss in males, it remained unclear, for LSA is composed of the xiphoid and the rib arch, and it is relatively fixed. We considered, the LSA may increases the space of abdominal cavity, leading to the difficulty and resulting in extra blood loss. Previous article reported that post-operative complications ranged from 6.1–30% [ 5 , 11 , 18 – 19 ]. These studies focused on BMI and visceral fat as for post-operative complications [ 20 – 21 ]. In this study, the rate of post-operative complications was 28.2% and patients with higher PAAD and APD had more complications. In univariate analysis, PAAD and APD were independent factors for predicting postoperative complications in males. It may be the large size of abdominal shape which affect the safety of LADG, so, surgeons should be cautious about patients with higher PAAD and APD. The number of retrieved lymph nodes is related to the effectiveness of the operation. Insufficient number of retrieved lymph nodes may lead to a poor prognosis [ 22 – 23 ]. In this study, lower APD, PAAD and SFT had more retrieved lymph nodes in males, it seems that smaller parameters of abdominal shape can make the surgery of LADG effective. So, much attention should be paid to patients with large parameters of abdominal shape, especially APD, PAAD and SFT. This study has some limitations as well. First, this is a retrospective study at a single center; Second, this study included patients undergoing LADG, there may be some patients who underwent open gastrostomy because of obesity or converted to open gastrostomy caused by the large amount of bleeding or the difficulty of LADG; Third, this study used CT to estimate the LSA. Ideally, we think the rib arch is a straight line, but actually, the rib arch is a curve and some patients had asymmetrical bilateral costal arches. The calculation of the angle in this study may have some deviation. Fourth, the proportion of women in this study is obviously too small, so the results of women may be biased because of the small amount of data. In conclusion, various abdominal shapes can influence the difficulty of LADG. Lower LSA and PAAD can reduce the difficulty of LADG in male patients. Therefore, a simple measurement of abdominal shape before surgery can predict the difficulty of surgery. Abbreviations LADG: The surgery of laparoscopic distal gastrectomy + D2 lymph node dissection. PAAD: The abdominal parameters including the shortest distance of the pancreas from the anterior abdominal skin. LSA: the lower sternum angle. SFT: the thickness of subcutaneous fat at the navel level. APD: the anteroposterior diameters at the navel level. LRD: left-right diameters at the navel level. XND: the distance from xiphoid process to the navel. XBD: the distance from xiphoid process to the pubis. Declarations Funding: No funding. Competing interests: The authors declare that they have no competing interests. Ethics Approval and Consent Statement: This study was conducted in accordance with the World Medical Association Declaration of Helsinki and was approved by the Medical Ethics Committee of the First Affiliated Hospital of Chongqing Medical University (2020-430). Consent to participate: Informed consent was obtained from all individual participants included in the study. Consent for publication: Patients signed informed consent regarding publishing their data and photographs. Data availability: The data of this study are available upon special request to the corresponding author(s). Acknowledgements: The authors are grateful for all the colleagues who helped in the preparation of this article. Disclosures statement: No competing financial interests exist. Authors' contributions: Dong Peng: Conceptualization, formal analysis, software, and writing-original draft. Wei Tao: Data curation, formal analysis and investigation, methodology. Yu-Xi Cheng: Data curation, formal analysis and investigation, resource. Ying-Ying Zou: Data curation, project administration, resources. Kun Qian: Conceptualization, project administration, supervision, writing—review and editing. Wei Zhang: Conceptualization, supervision, writing—review and editing. All authors read and approved the final manuscript. References Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68: 394-424. Nie Y, Wu K, Yu J, et al. A global burden of gastric cancer: the major impact of China. Expert Rev Gastroenterol Hepatol, 2017, 11: 651-661. Jung KW, Won YJ, Kong HyJ, et al. Prediction of cancer incidence and mortality in Korea, 2014. Cancer Res Treat, 2014, 46: 124-30. Kitano S, Iso Y, Moriyama M, et al. Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc, 1994, 4: 146-8. Kim W, Kim HH, Han SU, et al. Decreased Morbidity of Laparoscopic Distal Gastrectomy Compared with Open Distal Gastrectomy for Stage I Gastric Cancer: Short-term Outcomes from a Multicenter Randomized Controlled Trial (KLASS-01). Ann. Surg. 2016, 263: 28-35. Kambara Y, Yuasa N, Takeuchi E, et al. Overweight or Obesity is an Unfavorable Long-Term Prognostic Factor for Patients Who Underwent Gastrectomy for Stage II/III Gastric Cancer. World Journal of Surgery, 2019. Shimada S, Sawada N, Ishiyama Y, et al. Impact of obesity on short- and long-term outcomes of laparoscopy assisted distal gastrectomy for gastric cancer. Surg Endosc, 2018, 32: 358-366. Struecker B, Biebl M, Dadras M, et al. The Impact of Obesity on Outcomes Following Resection for Gastric Cancer. Dig Surg, 2017, 34: 133-141. HasbahcecI M, MehdI E, Malya F U, et al. Role of obesity and abdominal shape morphometric features to predict postoperative complications and quality of lymph node dissection of gastrectomy for gastric cancer. Neoplasma, 2017, 64: 922-932. Wang W, Ai KX, Tao F, et al. Impact of Abdominal Shape on Short-Term Surgical Outcome of Laparoscopy-Assisted Distal Gastrectomy for Gastric Cancer. J. Gastrointest. Surg, 2016, 20: 1091-7. Ojima T, Iwahashi M, Nakamori M, et al. The impact of abdominal shape index of patients on laparoscopy-assisted distal gastrectomy for early gastric cancer. Langenbecks Arch Surg, 2012, 397: 437-45. Chinese Medical Association. Laparoscopic surgical guideline for Gastric Carcinoma. (2007 Version). J Surg Concepts Pract 2007.12:610-614. Daniel Dindo. The Clavien–Dindo Classification of Surgical Complications.Treatment of Postoperative Complications After Digestive Surgery. 2014. Hiki N, Fukunaga T, Yamaguchi T, et al. Increased fat content and body shape have little effect on the accuracy of lymph node retrieval and blood loss in laparoscopic distal gastrectomy for gastric cancer. J. Gastrointest. Surg. 2009, 13: 626-33. Wu XS, Wu WG, Li ML, et al. Impact of being overweight on the surgical outcomes of patients with gastric cancer: a meta-analysis. World J. Gastroenterol. 2013, 19: 4596-606. Bickenbach KA, Denton B, Gonen M, et al. Impact of obesity on perioperative complications and long-term survival of patients with gastric cancer. Ann. Surg. Oncol, 2013, 20: 780-7. Lee JH, Paik YH, Lee JS, et al. Abdominal shape of gastric cancer patients influences short-term surgical outcomes. Ann. Surg. Oncol. 2007, 14: 1288-94. Ryu KW, Kim YW, Lee JH, et al. Surgical complications and the risk factors of laparoscopy-assisted distal gastrectomy in early gastric cancer. Ann. Surg. Oncol, 2008, 15: 1625-31. Kitano S, Shiraishi N, Uyama I, et al. A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann. Surg, 2007, 245: 68-72. Sugisawa N, Tokunaga M, Tanizawa Y, et al. Intra-abdominal infectious complications following gastrectomy in patients with excessive visceral fat. Gastric Cancer, 2012, 15: 206-12. Takeuchi M, Ishii K, Seki H, et al. Excessive visceral fat area as a risk factor for early postoperative complications of total gastrectomy for gastric cancer: a retrospective cohort study. BMC Surg, 2016, 16: 54. Vuong B, Graff BAN, Dehal A, et al. Survival Analysis with Extended Lymphadenectomy for Gastric Cancer: Removing Stage Migration from the Equation. Am Surg, 2017, 83: 1074-1079. Biondi A, D'Ugo D, Cananzi F C M et al. Does a minimum number of 16 retrieved nodes affect survival in curatively resected gastric cancer? Eur J Surg Oncol, 2015, 41: 779-86. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-84004","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research","associatedPublications":[],"authors":[{"id":2857435,"identity":"655e2cb1-6182-4d9f-affe-fd7f8d9feed9","order_by":0,"name":"Dong Peng","email":"","orcid":"https://orcid.org/0000-0003-4050-4337","institution":"The First Affiliated Hospital of Chongqing Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Dong","middleName":"","lastName":"Peng","suffix":""},{"id":2857436,"identity":"f657efb0-758d-490e-9f54-15b70f617616","order_by":1,"name":"Wei Tao","email":"","orcid":"","institution":"The First Affiliated Hospital of Chongqing Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Wei","middleName":"","lastName":"Tao","suffix":""},{"id":2857437,"identity":"cb1ba657-3803-4ca3-a04a-f7673495ae07","order_by":2,"name":"Yuxi Cheng","email":"","orcid":"","institution":"The First Affiliated Hospital of Chongqing Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yuxi","middleName":"","lastName":"Cheng","suffix":""},{"id":2857438,"identity":"9227bf0f-2207-4cdb-a5ed-ec68ac10d76e","order_by":3,"name":"Ying-Ying Zou","email":"","orcid":"","institution":"The First Affiliated Hospital of Chongqing Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Ying-Ying","middleName":"","lastName":"Zou","suffix":""},{"id":2857439,"identity":"45bab432-c90a-4ee4-86c7-b2b9bbc52446","order_by":4,"name":"Kun Qian","email":"","orcid":"","institution":"The First Affiliated Hospital of Chongqing Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Kun","middleName":"","lastName":"Qian","suffix":""},{"id":2857440,"identity":"e3584d70-da6c-444e-85ec-ad99064e7610","order_by":5,"name":"Wei Zhang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8klEQVRIiWNgGAWjYHACNgjFzHwMwmUnXgtbGgNDApDLTLQWBh4zsBYGQlr4Z6Q/e/BzR21iPzvPtwcff2yT52NmYPzwMQe3FokbCemGvWeOJ85s5t1uOCPhtmEbMwOz5MxtuLUYSCQck+BtO5a74TDvNmmehNuMQC1szLx4tSS2Sf4Fatl/mOcZSIs9EVqS2aR522pyNzDzsIG0JBLUInHmGZu0bNuB+hmH2cwkZ6TdTm5jZmzG6xf+9vRnkm/b6oz5+w8/k/hgc9t2fnvzwQ8f8WhhEEgAkYeRhRgb8KgHWXMARNbhVzQKRsEoGAUjGwAAqTRMjcPssacAAAAASUVORK5CYII=","orcid":"https://orcid.org/0000-0002-5822-9970","institution":"The First Affiliated Hospital of Chongqing Medical University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Wei","middleName":"","lastName":"Zhang","suffix":""}],"badges":[],"createdAt":"2020-09-26 11:38:34","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-84004/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-84004/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":2745356,"identity":"41a09654-5ef6-4ae0-9853-acbf4c56d89e","added_by":"auto","created_at":"2020-10-02 14:44:41","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":873647,"visible":true,"origin":"","legend":"Parameters of abdominal shape. \n(a) The shortest distance of the pancreas from the anterior abdominal skin (PAAD). (b) The thickness of subcutaneous fat at the navel level (SFT), the anteroposterior diameters (APD) and left-right diameters (LRD) at the navel level. (c) The lower sternum angle (LSA), the distance from xiphoid process to navel (XND), and the distance from xiphoid process to pubis (XBD).","description":"","filename":"Figure1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-84004/v1/Figure1.jpg"},{"id":2745357,"identity":"69eb8813-d15f-41ac-b430-a9e4156a8e25","added_by":"auto","created_at":"2020-10-02 14:44:42","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":1224326,"visible":true,"origin":"","legend":"Correlation between abdominal shape and retrieved lymph nodes.\nNote: In male patients, PAAD (p=0.006, k=-0.172), SFT (p=0.018, k=-0.149) and APD (p=0.004, k=-0.183) were correlated with the retrieved lymph nodes. but in female patients, all the abdominal shape parameters were negatively correlated with the retrieved lymph nodes (p\u003e0.05).","description":"","filename":"Figure2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-84004/v1/Figure2.jpg"},{"id":13597131,"identity":"0bce5a9c-bf55-4ade-b861-f22f3f766a0d","added_by":"auto","created_at":"2021-09-17 05:31:12","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":786065,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-84004/v1/b076d417-923a-420f-883e-f27cab8b6a30.pdf"}],"financialInterests":"","formattedTitle":"\u003cp\u003eThe Shortest Distance from the Skin to Pancreas and the Lower Sternum Angle can Influence Short-Term Surgical Outcomes of Laparoscopy-Assisted Distal Gastrectomy for Gastric Cancer\u003c/p\u003e","fulltext":[{"header":"Introduction","content":" \u003cp\u003eGastric cancer is one of the most common malignant tumors in the world, ranking fifth among all tumor incidences [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The incidence of gastric cancer in eastern countries is much higher than that in the west, especially in China, Japan, and South Korea [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The surgery of laparoscopic distal gastrectomy\u0026thinsp;+\u0026thinsp;D2 lymph node dissection (LADG) has been widely used since its first introduction [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e], and the laparoscopic surgical method is widely accepted because of cosmetics and less invasive than open surgical methods [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThere are many factors which can affect laparoscopic surgery. Obesity has always been considered as a factor that can not be ignored. Obesity may lead to a decrease in the number of retrieved lymph node, prolong hospital stay, and poor prognosis [\u003cspan additionalcitationids=\"CR7\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn addition to obesity, abdominal shape is also considered to be one of the factors that may affect laparoscopic surgery. At present, there is no certain standard for the measurement of abdominal shape. Most studies have focused on the measurement at the navel level, including the thickness of subcutaneous fat, the anteroposterior diameters and left-right diameters, and the area of ​​visceral fat [\u003cspan additionalcitationids=\"CR10\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. It was found that different abdominal shapes may affect short-term surgical outcomes of LADG.\u003c/p\u003e \u003cp\u003eFurthermore, abdominal shape is not only a structure at the navel level, but also a three-dimensional structure from xiphoid process to pubis. Therefore, parameters of other levels are needed. This study focused on some simple abdominal shape parameters and explored the effect on short-term surgical outcomes.\u003c/p\u003e "},{"header":"Materials And Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n\u003ch2\u003ePatients\u003c/h2\u003e\n\u003cp\u003eA retrospective research of gastric cancer patients who underwent LADG from January 2013 to June 2019\u0026nbsp;at a single clinical center was conducted in this study. Ethical approval from the Institutional Review Board was obtained. Patients were included by criteria as follows: 1, Patients who had undergone LADG successfully; and 2, Pathologically confirmed as gastric cancer. Totally, 418 patients were included according to the criteria. Patients were excluded by criteria as follows: 1, Neoadjuvant chemotherapy before surgery (n\u0026thinsp;=\u0026thinsp;12); 2, Incomplete preoperative abdominal computed tomography (CT) image data (n\u0026thinsp;=\u0026thinsp;75); 3, Absence of medical records (n\u0026thinsp;=\u0026thinsp;11); and 4, palliative surgery (n\u0026thinsp;=\u0026thinsp;4). A total of 316 patients were included in this study.\u003c/p\u003e\n\u003c/div\u003e\n\u003ch2\u003eSurgery\u003c/h2\u003e\n\u003cp\u003eAll patients included in this study underwent LADG, and they were operated by two surgeons with more than 10\u0026nbsp;years of surgical experience in a same team. The surgical methods were all standard LADG, and the scope of lymph node dissection conformed to the guidelines for laparoscopic surgery of the Chinese Society of Gastric Cancer [\u003cspan class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e\n\u003cp\u003eMedical records collections\u003c/p\u003e\n\u003cp\u003eClinical data were collected from the medical record database. The baseline information included gender, age, BMI, TNM stage (according to the UICC tumor lymph node metastasis classification system definition). The surgical information included operation time, estimated blood loss, postoperative hospital stay, the number of retrieved lymph nodes. The postoperative short-term complications included anastomotic leakage, intra-abdominal abscess, pneumonia, anastomotic bleeding, wound bleeding, wound infection, deterioration of liver function, chyle leakage, stenosis, heart disease, gastroparesis, pulmonary embolism, bowel obstruction, cerebral infarction, urinary tract infection, biliary fistula and death within 30 days after surgery according to Clavien-Dindo classification [\u003cspan class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e\n\u003ch2\u003eCT Image Data\u003c/h2\u003e\n\u003cp\u003eAll patients underwent abdomen CT examination within 14 days before the operation. The following parameters of equipment were adopted: the tube current was 150\u0026nbsp;mA; the tube voltage was 120 kVp; the section thickness was 5\u0026nbsp;mm; and the section interval was 5\u0026nbsp;mm. A 64 multi-detector scanner (LightSpeed VCT; GE Healthcare, Waukesha, WI, USA) was used for CT scanning. The scanning range was from the top of the chest to the bottom of the abdomen. An enhanced image was obtained after intravenous injection of 80\u0026ndash;90\u0026nbsp;mL of nonionic contrast agent (320\u0026nbsp;mg/mL; iopamidol, Shanghai Braco Sinus Pharmaceutical Co., Ltd., Shanghai, China) at an injection rate of 3.0\u0026nbsp;mL/s using a 50\u0026nbsp;mL saline tracker. The contrast agent-enhanced CT images were obtained 35 and 120\u0026nbsp;s after the injection of the contrast agent in the arterial phase and the equilibrium phase, respectively.\u003c/p\u003e\n\u003cp\u003eCT images were measured by the same physician who was blind to the patient\u0026rsquo;s clinical characteristics. The parameters included the shortest distance of the pancreas from the anterior abdominal skin (PAAD), the lower sternum angle (LSA), the thickness of subcutaneous fat at the navel level (SFT), the anteroposterior diameters(APD) and left-right diameters(LRD) at the navel level, the distance from xiphoid process to navel (XND), and the distance from xiphoid process to pubis (XBD).\u003c/p\u003e\n\u003cp\u003eThe PAAD was composed of the shortest vertical distance between the pancreas and the skin of the anterior abdomen in the CT image. The LSA was a downward opening angle formed by the combination of the rib arches and xiphoid process on both sides. It was the apex angle of the triangle formed by the lowermost part of the sternum and the costal arches on both sides, and it could also be called the upper abdominal angle. The calculation of the LSA: Calculating the distance from the anterior midline to the midclavicular line as A, and then Calculating the distance from the level at the intersection of the midclavicular line and the costal arch to the xiphoid process as B, after that, Using the formula LSA\u0026thinsp;=\u0026thinsp;2*DEGREES (ATAN (A / B)) to calculate LSA. The relevant data were entered and calculated using Microsoft Excel (2019). At the level of the navel, the distance from the anterior abdomen to the parietal peritoneum was defined as the SFT, the distance from the skin of the navel to the skin of the back was defined as the APD, and abdominal lateral diameter at the level of the anterior spine was the LRD (Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\n\u003ch2\u003eStatistical Analysis\u003c/h2\u003e\n\u003cp\u003eThe median and range was used for continuous variables that did not conform to the normal distribution. The \u0026chi;2 statistics, the Fisher's exact test or the Mann\u0026ndash;Whitney U test was used between two groups. The cutoff point of BMI was 25\u0026nbsp;kg/m2, and the cutoff point of other continuous variables was according to the median. Parameters were selected for univariate and multivariate analysis for detection of independent risk factors for postoperative complications. Correlation between the number of retrieved lymph nodes and the parameters of abdominal shape was analyzed by Pearson\u0026rsquo;s correlation test. Data were analyzed using SPSS (version 20.0) statistical software. A bilateral p value of \u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n\u003ch2\u003eClinical characteristics of the patients\u003c/h2\u003e\n\u003cp\u003eA total of 316 patients were included in this study, including 253 males and 63 females. The median age was 61 (28\u0026ndash;86) years. The median number of retrieved lymph nodes was 22 (6\u0026ndash;70). The time of operation was 200.0 (90.0-435.0) minutes. The estimated blood loss was 100.0 (10.0-2000.0) milliliter. The postoperative hospital stay was 10 (4\u0026ndash;66) days. The number of pathological stage of IA, IB, IIA, IIB, IIIA, IIIB, IIIC was 81, 37, 30, 53, 60, 41 and 14 (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab1\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eClinical characteristics of the patients\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eCharacteristics\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eNo.316\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eGender\u003c/p\u003e\n\u003cp\u003eMale\u003c/p\u003e\n\u003cp\u003eFemale\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e253 (80.1%)\u003c/p\u003e\n\u003cp\u003e63 (19.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAge, years (median, range)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e61 (28\u0026ndash;86)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTNM stage\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eI (IA/ IB)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e81/37\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eII (IIA/ IIB)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e30/53\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIII (IIIA/ IIIB/ IIIC)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e60/41/14\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eRetrieved lymph nodes (median, range)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e22 (6\u0026ndash;70)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eOperation time, minutes (median, range)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e200.0 (90.0-435.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEstimated blood loss, mL (median, range)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e100.0 (10.0-2000.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePostoperative hospital stay, day (median, range)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e10 (4\u0026ndash;66)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003ctfoot\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\"\u003eNote: Variables are expressed as the median and range, n (%).\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\"\u003eAbbreviations: BMI, body mass index; TNM, Tumor Node Metastasis.\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tfoot\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003ch2\u003eThe parameters of abdominal shape and BMI of patients\u003c/h2\u003e\n\u003cp\u003eBMI and seven parameters of abdominal shape were calculated between males and females by median and range. The SFT which was 14.9 (1.0-40.5) mm in males and 21.5 (5.8\u0026ndash;143.0) mm in females was significantly different (p\u0026thinsp;=\u0026thinsp;0.000), and the APD which was 176.2 (126.0-263.0) mm in males and 167.5 (122.2\u0026ndash;258.0) mm in females was significantly different as well (p\u0026thinsp;=\u0026thinsp;0.022). There was no difference between males and females as for other parameters of BMI, LSA, PAAD, LRD, XND and XBD. Therefore, males and females were discussed separately because of the difference of abdominal shape (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab2\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eBody shape and BMI of the patients\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eParameters\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eAll (n\u0026thinsp;=\u0026thinsp;316)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eMale (n\u0026thinsp;=\u0026thinsp;253)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eFemale (n\u0026thinsp;=\u0026thinsp;63)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eP value\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e22.3(15.0-35.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e22.5(15.0-34.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e22.1(17.48\u0026ndash;35.16)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.204\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLSA (\u0026deg;)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e82.8(43.9\u0026ndash;143.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e83.8(43.9\u0026ndash;143.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e80.6(54.3-140.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.122\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePAAD (mm)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e65.0(20.0-117.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e64.6(20.0-107.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e65.8(30.6-117.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.851\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSFT (mm)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e16.0(1.0-143.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e14.9(1.0-40.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e21.5(5.8\u0026ndash;143.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.000*\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAPD (mm)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e173.4(122.2\u0026ndash;263.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e176.2(126.0-263.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e167.5(122.2\u0026ndash;258.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.022*\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLRD (mm)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e290.0(206.2-380.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e290.0(206.2-380.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e288.5(231.4-359.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.632\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eXND (mm)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e215.0(95.0-340.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e215.0(95.0-340.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e210.0(165.0-280.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.966\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eXBD (mm)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e370.0(250.0-525.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e370.0(255.0-525.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e370.0(250.0-445.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.344\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003ctfoot\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"5\"\u003eNote: Variables are expressed as the the median and range, *P-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"5\"\u003eAbbreviations: BMI, body mass index; LSA, the angle of the lower sternum angle; PAAD, the shortest distance of the pancreas from the anterior abdominal skin; SFT, the thickness of subcutaneous fat at the navel level; APD, the anteroposterior diameters at the navel level; LRD, the left-right diameters at the navel level; XND, the distance from xiphoid process to navel; XBD, the distance from xiphoid process to pubis;\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tfoot\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/div\u003e\n\u003ch2\u003eShort-term surgical outcomes in patients\u003c/h2\u003e\n\u003cp\u003eThe cutoff point of BMI was 25\u0026nbsp;kg/m2, and other parameters were dichotomized according to the median. The parameters were divided into higher and lower groups. Short-term surgical outcomes were compared between higher and lower groups of BMI, LSA, PAAD, SFT, APD, LRD, XND and XBD. In males, the number of retrieved lymph nodes was significantly higher in patients with BMI\u0026thinsp;\u0026lt;\u0026thinsp;25\u0026nbsp;kg/m2(p\u0026thinsp;=\u0026thinsp;0.023) and APD\u0026thinsp;\u0026lt;\u0026thinsp;176.2\u0026nbsp;mm(p\u0026thinsp;=\u0026thinsp;0.004). The time of operation was significantly shorter in male patients with BMI\u0026thinsp;\u0026lt;\u0026thinsp;25\u0026nbsp;kg/m2(p\u0026thinsp;=\u0026thinsp;0.001), PAAD\u0026thinsp;\u0026lt;\u0026thinsp;64.6\u0026nbsp;mm(p\u0026thinsp;=\u0026thinsp;0.000), SFT\u0026thinsp;\u0026lt;\u0026thinsp;14.9\u0026nbsp;mm(p\u0026thinsp;=\u0026thinsp;0.017), APD\u0026thinsp;\u0026lt;\u0026thinsp;176.2\u0026nbsp;mm(p\u0026thinsp;=\u0026thinsp;0.002) and LRD\u0026thinsp;\u0026lt;\u0026thinsp;290.0\u0026nbsp;mm(p\u0026thinsp;=\u0026thinsp;0.036), and in female patients with XBD\u0026thinsp;\u0026gt;\u0026thinsp;370.0\u0026nbsp;mm(p\u0026thinsp;=\u0026thinsp;0.042). The estimated blood loss was significantly smaller in male patients with LSA\u0026thinsp;\u0026lt;\u0026thinsp;83.8\u0026deg;(p\u0026thinsp;=\u0026thinsp;0.009), PAAD\u0026thinsp;\u0026lt;\u0026thinsp;64.6\u0026nbsp;mm(p\u0026thinsp;=\u0026thinsp;0.001), APD\u0026thinsp;\u0026lt;\u0026thinsp;176.2\u0026nbsp;mm(p\u0026thinsp;=\u0026thinsp;0.0092), SFT\u0026thinsp;\u0026lt;\u0026thinsp;14.9\u0026nbsp;mm(p\u0026thinsp;=\u0026thinsp;0.001) and LRD\u0026thinsp;\u0026lt;\u0026thinsp;290.0\u0026nbsp;mm(p\u0026thinsp;=\u0026thinsp;0.011). The time of postoperative hospital stay was significantly shorter in male patients with APD\u0026thinsp;\u0026lt;\u0026thinsp;176.2\u0026nbsp;mm(p\u0026thinsp;=\u0026thinsp;0.033) and PAAD\u0026thinsp;\u0026lt;\u0026thinsp;65.8\u0026nbsp;mm(p\u0026thinsp;=\u0026thinsp;0.021). The complications were lower in male patients with PAAD\u0026thinsp;\u0026lt;\u0026thinsp;64.6\u0026nbsp;mm(p\u0026thinsp;=\u0026thinsp;0.045) and APD\u0026thinsp;\u0026lt;\u0026thinsp;176.2\u0026nbsp;mm(p\u0026thinsp;=\u0026thinsp;0.011), and in female patients with LRD\u0026thinsp;\u0026lt;\u0026thinsp;288.5\u0026nbsp;mm(p\u0026thinsp;=\u0026thinsp;0.047) (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e) (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab3\" style=\"width: 1025px;\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eShort-term surgical outcomes in male patients (n\u0026thinsp;=\u0026thinsp;253)\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth style=\"width: 168px;\" align=\"left\"\u003e\n\u003cp\u003eParameters\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"width: 153px;\" align=\"left\"\u003e\n\u003cp\u003eRetrieved lymph nodes\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"width: 171px;\" align=\"left\"\u003e\n\u003cp\u003eOperation time (minutes)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"width: 175px;\" align=\"left\"\u003e\n\u003cp\u003eEstimated blood loss (mL)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"width: 223px;\" align=\"left\"\u003e\n\u003cp\u003ePostoperative hospital stay (day)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"width: 95px;\" align=\"left\"\u003e\n\u003cp\u003eComplications\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 168px;\" align=\"left\"\u003e\n\u003cp\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u0026thinsp;\u0026ge;\u0026thinsp;25(n\u0026thinsp;=\u0026thinsp;56)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 153px;\" align=\"left\"\u003e\n\u003cp\u003e18.5(6\u0026ndash;42)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 171px;\" align=\"left\"\u003e\n\u003cp\u003e232.5(110\u0026ndash;435)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 175px;\" align=\"left\"\u003e\n\u003cp\u003e100(10-1800)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 223px;\" align=\"left\"\u003e\n\u003cp\u003e10(6\u0026ndash;23)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95px;\" align=\"left\"\u003e\n\u003cp\u003e18\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 168px;\" align=\"left\"\u003e\n\u003cp\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u0026thinsp;\u0026lt;\u0026thinsp;25(n\u0026thinsp;=\u0026thinsp;197)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 153px;\" align=\"left\"\u003e\n\u003cp\u003e22(6\u0026ndash;70)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 171px;\" align=\"left\"\u003e\n\u003cp\u003e197(90\u0026ndash;395)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 175px;\" align=\"left\"\u003e\n\u003cp\u003e100(20-2000)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 223px;\" align=\"left\"\u003e\n\u003cp\u003e10(4\u0026ndash;62)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95px;\" align=\"left\"\u003e\n\u003cp\u003e59\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 168px;\" align=\"left\"\u003e\n\u003cp\u003eP value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 153px;\" align=\"left\"\u003e\n\u003cp\u003e0.023*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 171px;\" align=\"left\"\u003e\n\u003cp\u003e0.001*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 175px;\" align=\"left\"\u003e\n\u003cp\u003e0.179\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 223px;\" align=\"left\"\u003e\n\u003cp\u003e0.508\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95px;\" align=\"left\"\u003e\n\u003cp\u003e0.753\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 168px;\" align=\"left\"\u003e\n\u003cp\u003eLSA (\u0026deg;)\u0026thinsp;\u0026ge;\u0026thinsp;83.8(126)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 153px;\" align=\"left\"\u003e\n\u003cp\u003e22(6\u0026ndash;43)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 171px;\" align=\"left\"\u003e\n\u003cp\u003e205.5(90\u0026ndash;435)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 175px;\" align=\"left\"\u003e\n\u003cp\u003e100(10-1800)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 223px;\" align=\"left\"\u003e\n\u003cp\u003e10(4\u0026ndash;62)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95px;\" align=\"left\"\u003e\n\u003cp\u003e44\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 168px;\" align=\"left\"\u003e\n\u003cp\u003eLSA (\u0026deg;)\u0026thinsp;\u0026lt;\u0026thinsp;83.8(n\u0026thinsp;=\u0026thinsp;127)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 153px;\" align=\"left\"\u003e\n\u003cp\u003e22(6\u0026ndash;70)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 171px;\" align=\"left\"\u003e\n\u003cp\u003e200(95\u0026ndash;380)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 175px;\" align=\"left\"\u003e\n\u003cp\u003e100(20-2000)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 223px;\" align=\"left\"\u003e\n\u003cp\u003e10(5\u0026ndash;33)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95px;\" align=\"left\"\u003e\n\u003cp\u003e33\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 168px;\" align=\"left\"\u003e\n\u003cp\u003eP value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 153px;\" align=\"left\"\u003e\n\u003cp\u003e0.694\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 171px;\" align=\"left\"\u003e\n\u003cp\u003e0.180\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 175px;\" align=\"left\"\u003e\n\u003cp\u003e0.009*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 223px;\" align=\"left\"\u003e\n\u003cp\u003e0.317\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95px;\" align=\"left\"\u003e\n\u003cp\u003e0.122\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 168px;\" align=\"left\"\u003e\n\u003cp\u003ePAAD (mm)\u0026thinsp;\u0026ge;\u0026thinsp;64.6(n\u0026thinsp;=\u0026thinsp;127)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 153px;\" align=\"left\"\u003e\n\u003cp\u003e20(6\u0026ndash;45)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 171px;\" align=\"left\"\u003e\n\u003cp\u003e225(90\u0026ndash;435)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 175px;\" align=\"left\"\u003e\n\u003cp\u003e100(10-2000)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 223px;\" align=\"left\"\u003e\n\u003cp\u003e10(5\u0026ndash;62)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95px;\" align=\"left\"\u003e\n\u003cp\u003e46\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 168px;\" align=\"left\"\u003e\n\u003cp\u003ePAAD (mm)\u0026thinsp;\u0026lt;\u0026thinsp;64.6(n\u0026thinsp;=\u0026thinsp;126)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 153px;\" align=\"left\"\u003e\n\u003cp\u003e22(6\u0026ndash;70)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 171px;\" align=\"left\"\u003e\n\u003cp\u003e190(95\u0026ndash;395)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 175px;\" align=\"left\"\u003e\n\u003cp\u003e100(20\u0026ndash;500)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 223px;\" align=\"left\"\u003e\n\u003cp\u003e10(4\u0026ndash;50)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95px;\" align=\"left\"\u003e\n\u003cp\u003e31\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 168px;\" align=\"left\"\u003e\n\u003cp\u003eP value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 153px;\" align=\"left\"\u003e\n\u003cp\u003e0.052\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 171px;\" align=\"left\"\u003e\n\u003cp\u003e0.000*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 175px;\" align=\"left\"\u003e\n\u003cp\u003e0.001*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 223px;\" align=\"left\"\u003e\n\u003cp\u003e0.302\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95px;\" align=\"left\"\u003e\n\u003cp\u003e0.045*\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 168px;\" align=\"left\"\u003e\n\u003cp\u003eSFT (mm)\u0026thinsp;\u0026ge;\u0026thinsp;14.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 153px;\" align=\"left\"\u003e\n\u003cp\u003e20(6\u0026ndash;45)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 171px;\" align=\"left\"\u003e\n\u003cp\u003e211.5(90\u0026ndash;435)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 175px;\" align=\"left\"\u003e\n\u003cp\u003e100(20-1800)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 223px;\" align=\"left\"\u003e\n\u003cp\u003e10(5\u0026ndash;26)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95px;\" align=\"left\"\u003e\n\u003cp\u003e45\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 168px;\" align=\"left\"\u003e\n\u003cp\u003eSFT (mm)\u0026thinsp;\u0026lt;\u0026thinsp;14.9(n\u0026thinsp;=\u0026thinsp;127)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 153px;\" align=\"left\"\u003e\n\u003cp\u003e22(6\u0026ndash;70)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 171px;\" align=\"left\"\u003e\n\u003cp\u003e195(95\u0026ndash;370)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 175px;\" align=\"left\"\u003e\n\u003cp\u003e100(10-2000)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 223px;\" align=\"left\"\u003e\n\u003cp\u003e10(4\u0026ndash;50)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95px;\" align=\"left\"\u003e\n\u003cp\u003e32\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 168px;\" align=\"left\"\u003e\n\u003cp\u003eP value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 153px;\" align=\"left\"\u003e\n\u003cp\u003e0.075\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 171px;\" align=\"left\"\u003e\n\u003cp\u003e0.017*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 175px;\" align=\"left\"\u003e\n\u003cp\u003e0.001*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 223px;\" align=\"left\"\u003e\n\u003cp\u003e0.636\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95px;\" align=\"left\"\u003e\n\u003cp\u003e0.069\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 168px;\" align=\"left\"\u003e\n\u003cp\u003eAPD (mm)\u0026thinsp;\u0026ge;\u0026thinsp;176.2(n\u0026thinsp;=\u0026thinsp;126)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 153px;\" align=\"left\"\u003e\n\u003cp\u003e19(6\u0026ndash;42)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 171px;\" align=\"left\"\u003e\n\u003cp\u003e215(90\u0026ndash;435)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 175px;\" align=\"left\"\u003e\n\u003cp\u003e100(10-2000)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 223px;\" align=\"left\"\u003e\n\u003cp\u003e11(4\u0026ndash;62)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95px;\" align=\"left\"\u003e\n\u003cp\u003e48\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 168px;\" align=\"left\"\u003e\n\u003cp\u003eAPD (mm)\u0026thinsp;\u0026lt;\u0026thinsp;176.2(n\u0026thinsp;=\u0026thinsp;127)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 153px;\" align=\"left\"\u003e\n\u003cp\u003e23(6\u0026ndash;70)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 171px;\" align=\"left\"\u003e\n\u003cp\u003e190(95\u0026ndash;395)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 175px;\" align=\"left\"\u003e\n\u003cp\u003e100(20\u0026ndash;500)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 223px;\" align=\"left\"\u003e\n\u003cp\u003e10(6\u0026ndash;50)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95px;\" align=\"left\"\u003e\n\u003cp\u003e29\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 168px;\" align=\"left\"\u003e\n\u003cp\u003eP value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 153px;\" align=\"left\"\u003e\n\u003cp\u003e0.004*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 171px;\" align=\"left\"\u003e\n\u003cp\u003e0.002*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 175px;\" align=\"left\"\u003e\n\u003cp\u003e0.002*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 223px;\" align=\"left\"\u003e\n\u003cp\u003e0.033*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95px;\" align=\"left\"\u003e\n\u003cp\u003e0.011*\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 168px;\" align=\"left\"\u003e\n\u003cp\u003eLRD (mm)\u0026thinsp;\u0026ge;\u0026thinsp;290.0(n\u0026thinsp;=\u0026thinsp;127)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 153px;\" align=\"left\"\u003e\n\u003cp\u003e20(6\u0026ndash;42)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 171px;\" align=\"left\"\u003e\n\u003cp\u003e210(98\u0026ndash;435)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 175px;\" align=\"left\"\u003e\n\u003cp\u003e100(10-2000)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 223px;\" align=\"left\"\u003e\n\u003cp\u003e10(4\u0026ndash;62)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95px;\" align=\"left\"\u003e\n\u003cp\u003e45\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 168px;\" align=\"left\"\u003e\n\u003cp\u003eLRD (mm)\u0026thinsp;\u0026lt;\u0026thinsp;290.0(n\u0026thinsp;=\u0026thinsp;126)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 153px;\" align=\"left\"\u003e\n\u003cp\u003e22(6\u0026ndash;70)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 171px;\" align=\"left\"\u003e\n\u003cp\u003e195(90\u0026ndash;395)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 175px;\" align=\"left\"\u003e\n\u003cp\u003e100(20\u0026ndash;800)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 223px;\" align=\"left\"\u003e\n\u003cp\u003e10(6\u0026ndash;50)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95px;\" align=\"left\"\u003e\n\u003cp\u003e32\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 168px;\" align=\"left\"\u003e\n\u003cp\u003eP value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 153px;\" align=\"left\"\u003e\n\u003cp\u003e0.307\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 171px;\" align=\"left\"\u003e\n\u003cp\u003e0.036*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 175px;\" align=\"left\"\u003e\n\u003cp\u003e0.011*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 223px;\" align=\"left\"\u003e\n\u003cp\u003e0.399\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95px;\" align=\"left\"\u003e\n\u003cp\u003e0.083\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 168px;\" align=\"left\"\u003e\n\u003cp\u003eXND (mm)\u0026thinsp;\u0026ge;\u0026thinsp;215.0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 153px;\" align=\"left\"\u003e\n\u003cp\u003e20(6\u0026ndash;47)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 171px;\" align=\"left\"\u003e\n\u003cp\u003e205(90\u0026ndash;435)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 175px;\" align=\"left\"\u003e\n\u003cp\u003e100(10-1800)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 223px;\" align=\"left\"\u003e\n\u003cp\u003e10(4\u0026ndash;62)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95px;\" align=\"left\"\u003e\n\u003cp\u003e40\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 168px;\" align=\"left\"\u003e\n\u003cp\u003eXND (mm)\u0026thinsp;\u0026lt;\u0026thinsp;215.0(n\u0026thinsp;=\u0026thinsp;121)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 153px;\" align=\"left\"\u003e\n\u003cp\u003e22(6\u0026ndash;70)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 171px;\" align=\"left\"\u003e\n\u003cp\u003e195(95\u0026ndash;348)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 175px;\" align=\"left\"\u003e\n\u003cp\u003e100(20-2000)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 223px;\" align=\"left\"\u003e\n\u003cp\u003e10(6\u0026ndash;29)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95px;\" align=\"left\"\u003e\n\u003cp\u003e37\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 168px;\" align=\"left\"\u003e\n\u003cp\u003eP value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 153px;\" align=\"left\"\u003e\n\u003cp\u003e0.081\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 171px;\" align=\"left\"\u003e\n\u003cp\u003e0.228\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 175px;\" align=\"left\"\u003e\n\u003cp\u003e0.157\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 223px;\" align=\"left\"\u003e\n\u003cp\u003e0.858\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95px;\" align=\"left\"\u003e\n\u003cp\u003e0.962\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 168px;\" align=\"left\"\u003e\n\u003cp\u003eXBD (mm)\u0026thinsp;\u0026ge;\u0026thinsp;370.0(n\u0026thinsp;=\u0026thinsp;135)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 153px;\" align=\"left\"\u003e\n\u003cp\u003e20(6\u0026ndash;47)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 171px;\" align=\"left\"\u003e\n\u003cp\u003e205(90\u0026ndash;435)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 175px;\" align=\"left\"\u003e\n\u003cp\u003e100(10-1800)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 223px;\" align=\"left\"\u003e\n\u003cp\u003e10(4\u0026ndash;42)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95px;\" align=\"left\"\u003e\n\u003cp\u003e39\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 168px;\" align=\"left\"\u003e\n\u003cp\u003eXBD (mm)\u0026thinsp;\u0026lt;\u0026thinsp;370.0(n\u0026thinsp;=\u0026thinsp;118)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 153px;\" align=\"left\"\u003e\n\u003cp\u003e22(6\u0026ndash;70)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 171px;\" align=\"left\"\u003e\n\u003cp\u003e196(95\u0026ndash;375)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 175px;\" align=\"left\"\u003e\n\u003cp\u003e100(20-2000)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 223px;\" align=\"left\"\u003e\n\u003cp\u003e10(5\u0026ndash;62)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95px;\" align=\"left\"\u003e\n\u003cp\u003e38\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 168px;\" align=\"left\"\u003e\n\u003cp\u003eP value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 153px;\" align=\"left\"\u003e\n\u003cp\u003e0.274\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 171px;\" align=\"left\"\u003e\n\u003cp\u003e0.266\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 175px;\" align=\"left\"\u003e\n\u003cp\u003e0.240\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 223px;\" align=\"left\"\u003e\n\u003cp\u003e0.715\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 95px;\" align=\"left\"\u003e\n\u003cp\u003e0.568\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003ctfoot\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 985px;\" colspan=\"6\"\u003eNote: Variables are expressed as the median and range, *P-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 985px;\" colspan=\"6\"\u003eAbbreviations: BMI, body mass index; LSA, the angle of the lower sternum angle; PAAD, the shortest distance of the pancreas from the anterior abdominal skin; SFT, the thickness of subcutaneous fat at the navel level; APD, the anteroposterior diameters at the navel level; LRD, the left-right diameters at the navel level; XND, the distance from xiphoid process to navel; XBD, the distance from xiphoid process to pubis;\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tfoot\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab4\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eShort-term surgical outcomes in female patients (n\u0026thinsp;=\u0026thinsp;63)\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eParameters\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eRetrieved lymph nodes\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eOperation time (minutes)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eEstimated blood loss (mL)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003ePostoperative hospital stay (day)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eComplications\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBMI (kg/m2)\u0026thinsp;\u0026ge;\u0026thinsp;25(n\u0026thinsp;=\u0026thinsp;7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e27(11\u0026ndash;33)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e210(120\u0026ndash;315)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50(40\u0026ndash;100)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e11(7\u0026ndash;16)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBMI (kg/m2)\u0026thinsp;\u0026lt;\u0026thinsp;25(n\u0026thinsp;=\u0026thinsp;56)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e23(7\u0026ndash;45)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e197.5(100\u0026ndash;310)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50(10-1000)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8.5(4\u0026ndash;66)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e11\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.569\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.463\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.351\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.127\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLSA (\u0026deg;)\u0026thinsp;\u0026ge;\u0026thinsp;80.6(n\u0026thinsp;=\u0026thinsp;33)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e23(8\u0026ndash;40)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e205(100\u0026ndash;315)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50(20-1000)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9(6\u0026ndash;66)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLSA (\u0026deg;)\u0026thinsp;\u0026lt;\u0026thinsp;80.6(n\u0026thinsp;=\u0026thinsp;30)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24(7\u0026ndash;45)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e187.5(110\u0026ndash;303)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50(10\u0026ndash;300)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8.5(4\u0026ndash;51)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e7\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.710\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.397\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.533\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.323\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.409\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePAAD (mm)\u0026thinsp;\u0026ge;\u0026thinsp;65.8(n\u0026thinsp;=\u0026thinsp;31)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e22(8\u0026ndash;45)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e200(100\u0026ndash;315)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50(20\u0026ndash;300)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e10(7\u0026ndash;66)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePAAD (mm)\u0026thinsp;\u0026lt;\u0026thinsp;65.8(n\u0026thinsp;=\u0026thinsp;32)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24(7\u0026ndash;45)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e195(115\u0026ndash;310)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50(10-1000)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8(4\u0026ndash;51)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.364\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.700\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.524\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.021*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.951\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSFT (mm)\u0026thinsp;\u0026ge;\u0026thinsp;21.5(n\u0026thinsp;=\u0026thinsp;31)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e22(8\u0026ndash;35)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e195(110\u0026ndash;315)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50(20\u0026ndash;300)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e10(6\u0026ndash;66)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e7\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSFT (mm)\u0026thinsp;\u0026lt;\u0026thinsp;21.5(n\u0026thinsp;=\u0026thinsp;32)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24.5(7\u0026ndash;45)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e200(100\u0026ndash;310)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e75(10-1000)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8(4\u0026ndash;35)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.141\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.891\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.244\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.158\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.482\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAPD (mm)\u0026thinsp;\u0026ge;\u0026thinsp;167.5(n\u0026thinsp;=\u0026thinsp;31)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e22(8\u0026ndash;33)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e195(100\u0026ndash;315)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50(20-1000)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e10(7\u0026ndash;66)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e7\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAPD (mm)\u0026thinsp;\u0026lt;\u0026thinsp;167.5(n\u0026thinsp;=\u0026thinsp;32)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e25(7\u0026ndash;45)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e200(115\u0026ndash;303)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e75(10\u0026ndash;400)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8(4\u0026ndash;51)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.107\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.767\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.182\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.249\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.482\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLRD (mm)\u0026thinsp;\u0026ge;\u0026thinsp;288.5(n\u0026thinsp;=\u0026thinsp;31)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e23(7\u0026ndash;33)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e210(100\u0026ndash;315)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50(20\u0026ndash;400)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e10(4\u0026ndash;66)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLRD (mm)\u0026thinsp;\u0026lt;\u0026thinsp;288.5(n\u0026thinsp;=\u0026thinsp;32)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24(10\u0026ndash;45)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e178.5(115\u0026ndash;310)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50(10-1000)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8(6\u0026ndash;51)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.066\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.100\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.930\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.158\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.047*\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eXND (mm)\u0026thinsp;\u0026ge;\u0026thinsp;210.0(n\u0026thinsp;=\u0026thinsp;37)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e23(7\u0026ndash;45)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e190(100\u0026ndash;310)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50(10-1000)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9(4\u0026ndash;66)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eXND (mm)\u0026thinsp;\u0026lt;\u0026thinsp;210.0(n\u0026thinsp;=\u0026thinsp;26)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24.5(8\u0026ndash;39)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e207.5(130\u0026ndash;315)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e75(20\u0026ndash;400)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8.5(6\u0026ndash;53)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.375\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.079\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.246\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.805\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.329\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eXBD (mm)\u0026thinsp;\u0026ge;\u0026thinsp;370.0(n\u0026thinsp;=\u0026thinsp;38)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e23.5(8\u0026ndash;45)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e187.5(100\u0026ndash;310)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50(10-1000)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8(6\u0026ndash;66)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eXBD (mm)\u0026thinsp;\u0026lt;\u0026thinsp;370.0(n\u0026thinsp;=\u0026thinsp;25)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24(7\u0026ndash;39)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e210(135\u0026ndash;315)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e100(20\u0026ndash;300)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e10(4\u0026ndash;53)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.807\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.042*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.315\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.166\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.521\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003ctfoot\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"6\"\u003eNote: Variables are expressed as the median and range, *P-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"6\"\u003eAbbreviations: BMI, body mass index; LSA, the angle of the lower sternum angle; PAAD, the shortest distance of the pancreas from the anterior abdominal skin; SFT, the thickness of subcutaneous fat at the navel level; APD, the anteroposterior diameters at the navel level; LRD, the left-right diameters at the navel level; XND, the distance from xiphoid process to navel; XBD, the distance from xiphoid process to pubis;\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tfoot\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/div\u003e\n\u003ch2\u003ePredictive factors for postoperative complications\u003c/h2\u003e\n\u003cp\u003eEighty-nine patients had postoperative complications, the highest complication was pneumonia (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e6\u003c/span\u003e). Univariate analysis was used for postoperative complications, and it was found that PAAD (p\u0026thinsp;=\u0026thinsp;0.046, odds ratio\u0026thinsp;=\u0026thinsp;1.740, 95%CI\u0026thinsp;=\u0026thinsp;1.011\u0026ndash;2.997) and APD (p\u0026thinsp;=\u0026thinsp;0.011, odds ratio\u0026thinsp;=\u0026thinsp;2.032, 95%CI\u0026thinsp;=\u0026thinsp;1.174\u0026ndash;3.517) were independent factors for predicting postoperative complications in males. however, in multivariate analysis, PAAD and APD showed no difference in males. In females, there was no difference in univariate and multivariate analysis (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab6\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eUnivariate and multivariate analysis of predictive factors for postoperative complications\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eRisk factors\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eUnivariate analysis\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eMultivariate analysis\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eMale\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eFemale\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eMale\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eP value\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eOdds ratio\u003c/p\u003e\n\u003cp\u003e(95% CI)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eP value\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eOdds ratio\u003c/p\u003e\n\u003cp\u003e(95% CI)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eP value\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eOdds ratio\u003c/p\u003e\n\u003cp\u003e(95% CI)\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBMI (kg/m2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.753\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.108\u003c/p\u003e\n\u003cp\u003e(0.585\u0026ndash;2.098)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.735\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.682\u003c/p\u003e\n\u003cp\u003e(0.074\u0026ndash;6.261)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLSA (\u0026deg;)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.123\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.528\u003c/p\u003e\n\u003cp\u003e(0.891\u0026ndash;2.622)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.412\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.587\u003c/p\u003e\n\u003cp\u003e(0.164\u0026ndash;2.096)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePAAD (mm)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.046*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.740\u003c/p\u003e\n\u003cp\u003e(1.011\u0026ndash;2.997)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.951\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.040\u003c/p\u003e\n\u003cp\u003e(0.296\u0026ndash;3.658)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.616\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.197\u003c/p\u003e\n\u003cp\u003e(0.594\u0026ndash;2.413)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSFT (mm)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.070\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.649\u003c/p\u003e\n\u003cp\u003e(0.960\u0026ndash;2.835)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.484\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.575\u003c/p\u003e\n\u003cp\u003e(0.441\u0026ndash;5.623)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAPD (mm)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.011*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.032\u003c/p\u003e\n\u003cp\u003e(1.174\u0026ndash;3.517)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.484\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.575\u003c/p\u003e\n\u003cp\u003e(0.441\u0026ndash;5.623)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.097\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.814\u003c/p\u003e\n\u003cp\u003e(0.897\u0026ndash;3.668)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLRD (mm)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.084\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.612\u003c/p\u003e\n\u003cp\u003e(0.938\u0026ndash;2.770)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.058\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.955\u003c/p\u003e\n\u003cp\u003e(0.957\u0026ndash;16.349)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eXND (mm)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.962\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.987\u003c/p\u003e\n\u003cp\u003e(0.577\u0026ndash;1.687)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.213\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.464\u003c/p\u003e\n\u003cp\u003e(0.597\u0026ndash;10.178)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eXBD (mm)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.568\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.855\u003c/p\u003e\n\u003cp\u003e(0.500-1.462)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.449\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.613\u003c/p\u003e\n\u003cp\u003e(0.173\u0026ndash;2.177)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003ctfoot\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"7\"\u003eNote: Variables are dichotomized according to the median, *P-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"7\"\u003eAbbreviations: BMI, body mass index; LSA, the angle of the lower sternum angle; PAAD, the shortest distance of the pancreas from the anterior abdominal skin; SFT, the thickness of subcutaneous fat at the navel level; APD, the anteroposterior diameters at the navel level; LRD, the left-right diameters at the navel level; XND, the distance from xiphoid process to navel; XBD, the distance from xiphoid process to pubis; OR, odds ratio; CI, confidence interval.\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tfoot\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab5\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003ePostoperative complications\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eComplications\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eAll\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eMale\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eFemale\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAnastomotic leakage\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e18\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e16\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIntra-abdominal abscess\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePneumonia\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e32\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e31\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAnastomotic bleeding\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eWound bleeding\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eWound infection\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDeterioration of liver function\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eChyle leakage\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eStenosis\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHeart disease\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eGastroparesis\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePulmonary\u0026nbsp;embolism\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ebowel obstruction\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCerebral infarction\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eUrinary tract infection\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBiliary fistula\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDeath\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTotal\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e89\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e77\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e12\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003ctfoot\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"4\"\u003eNote: Variables are expressed as n.\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tfoot\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/div\u003e\n\u003ch2\u003eCorrelation between abdominal shape parameters and retrieved lymph nodes\u003c/h2\u003e\n\u003cp\u003eThere was no difference between the number of retrieved lymph nodes and the parameters of abdominal shape in females (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). In males, PAAD (p\u0026thinsp;=\u0026thinsp;0.006, k=-0.172), SFT (p\u0026thinsp;=\u0026thinsp;0.018, k=-0.149) and APD (p\u0026thinsp;=\u0026thinsp;0.004, k=-0.183) were correlated with the retrieved lymph nodes (Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e"},{"header":"Discussion","content":" \u003cp\u003eThis study innovatively explored simple index of abdominal shape of PAAD, LSA and other parameters on short-term surgical outcomes in patients undergoing LADG. We found that abdominal shape can influence operation time, estimated blood loss, postoperative hospital stay, the number of retrieved lymph nodes and complications. Furthermore, abdominal body shape differed between two genders, males had larger APD and smaller SFT over females. Therefore, we analyzed males and females separately and found that few abdominal shape parameters had an impact on short-term surgical outcomes in females. However, in males, we found some abdominal shape parameters were crucial. The result was consistent with the previously published literature [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eObesity has always been considered an independent factor in patients with gastric cancer. BMI can be a parameter to represent obesity. Some studies believed that BMI has an impact on postoperative complications and survival [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. In this study, males with BMI\u0026thinsp;\u0026lt;\u0026thinsp;25 had less operation time and larger number of retrieved lymph nodes. It can be seen that obesity has an impact on the difficulty of LADG in male patients.\u003c/p\u003e \u003cp\u003eThe operation time and estimated blood loss can reflect the difficulty of the operation. Previous studies have found that large APD can increase the operation time and Large LRD can increase the amount of surgical bleeding [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. In this study, larger PAAD, SFT, APD and LRD contributed to increase of operation time in males, and smaller XBD contributed to increase of operation time in females. As for estimated blood loss, patients with larger LSA, PAAD, APD, SFT and LRD could experience larger amount of estimated blood loss in males, but all parameters had negative relationship with females. Different distensibility of abdominal wall in men and women due to accumulation of muscle and lipid may explain why abdominal shape was more strongly associated with male patients than female patients [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. The extra operation time and blood loss may be the large size of abdominal shape and excess fat tissues accumulated around vessels [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. As for larger LSA resulted in larger amount of estimated blood loss in males, it remained unclear, for LSA is composed of the xiphoid and the rib arch, and it is relatively fixed. We considered, the LSA may increases the space of abdominal cavity, leading to the difficulty and resulting in extra blood loss.\u003c/p\u003e \u003cp\u003ePrevious article reported that post-operative complications ranged from 6.1\u0026ndash;30% [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. These studies focused on BMI and visceral fat as for post-operative complications [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. In this study, the rate of post-operative complications was 28.2% and patients with higher PAAD and APD had more complications. In univariate analysis, PAAD and APD were independent factors for predicting postoperative complications in males. It may be the large size of abdominal shape which affect the safety of LADG, so, surgeons should be cautious about patients with higher PAAD and APD.\u003c/p\u003e \u003cp\u003eThe number of retrieved lymph nodes is related to the effectiveness of the operation. Insufficient number of retrieved lymph nodes may lead to a poor prognosis [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. In this study, lower APD, PAAD and SFT had more retrieved lymph nodes in males, it seems that smaller parameters of abdominal shape can make the surgery of LADG effective. So, much attention should be paid to patients with large parameters of abdominal shape, especially APD, PAAD and SFT.\u003c/p\u003e \u003cp\u003eThis study has some limitations as well. First, this is a retrospective study at a single center; Second, this study included patients undergoing LADG, there may be some patients who underwent open gastrostomy because of obesity or converted to open gastrostomy caused by the large amount of bleeding or the difficulty of LADG; Third, this study used CT to estimate the LSA. Ideally, we think the rib arch is a straight line, but actually, the rib arch is a curve and some patients had asymmetrical bilateral costal arches. The calculation of the angle in this study may have some deviation. Fourth, the proportion of women in this study is obviously too small, so the results of women may be biased because of the small amount of data.\u003c/p\u003e \u003cp\u003eIn conclusion, various abdominal shapes can influence the difficulty of LADG. Lower LSA and PAAD can reduce the difficulty of LADG in male patients. Therefore, a simple measurement of abdominal shape before surgery can predict the difficulty of surgery.\u003c/p\u003e "},{"header":"Abbreviations","content":"\u003cp\u003eLADG: The surgery of laparoscopic distal gastrectomy + D2 lymph node dissection.\u003c/p\u003e\n\u003cp\u003ePAAD: The abdominal parameters including the shortest distance of the pancreas from the anterior abdominal skin.\u003c/p\u003e\n\u003cp\u003eLSA: the lower sternum angle.\u003c/p\u003e\n\u003cp\u003eSFT: the thickness of subcutaneous fat at the navel level.\u003c/p\u003e\n\u003cp\u003eAPD: the anteroposterior diameters at the navel level.\u003c/p\u003e\n\u003cp\u003eLRD: left-right diameters at the navel level.\u003c/p\u003e\n\u003cp\u003eXND: the distance from xiphoid process to the navel.\u003c/p\u003e\n\u003cp\u003eXBD: the distance from xiphoid process to the pubis.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics Approval and Consent Statement: \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in accordance with the World Medical Association Declaration of Helsinki and was approved by the Medical Ethics Committee of the First Affiliated Hospital of Chongqing Medical University (2020-430).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent was obtained from all individual participants included in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePatients signed informed consent regarding publishing their data and photographs.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data of this study are available upon special request to the corresponding author(s).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements: \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors are grateful for all the colleagues who helped in the preparation of this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDisclosures statement:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo competing financial interests exist.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDong Peng: Conceptualization, formal analysis, software, and writing-original draft.\u003c/p\u003e\n\u003cp\u003eWei Tao: Data curation, formal analysis and investigation, methodology.\u003c/p\u003e\n\u003cp\u003eYu-Xi Cheng: Data curation, formal analysis and investigation, resource.\u003c/p\u003e\n\u003cp\u003eYing-Ying Zou: Data curation, project administration, resources.\u003c/p\u003e\n\u003cp\u003eKun Qian: Conceptualization, project administration, supervision, writing\u0026mdash;review and editing.\u003c/p\u003e\n\u003cp\u003eWei Zhang: Conceptualization, supervision, writing\u0026mdash;review and editing.\u003c/p\u003e\n\u003cp\u003eAll authors read and approved the final manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68: 394-424.\u003c/li\u003e\n\u003cli\u003eNie Y, Wu K, Yu J, et al. A global burden of gastric cancer: the major impact of China. Expert Rev Gastroenterol Hepatol, 2017, 11: 651-661.\u003c/li\u003e\n\u003cli\u003eJung KW, Won YJ, Kong HyJ, et al. Prediction of cancer incidence and mortality in Korea, 2014. Cancer Res Treat, 2014, 46: 124-30.\u003c/li\u003e\n\u003cli\u003eKitano S, Iso Y, Moriyama M, et al. Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc, 1994, 4: 146-8.\u003c/li\u003e\n\u003cli\u003eKim W, Kim HH, Han SU, et al. Decreased Morbidity of Laparoscopic Distal Gastrectomy Compared with Open Distal Gastrectomy for Stage I Gastric Cancer: Short-term Outcomes from a Multicenter Randomized Controlled Trial (KLASS-01). Ann. Surg. 2016, 263: 28-35.\u003c/li\u003e\n\u003cli\u003eKambara Y, Yuasa N, Takeuchi E, et al. Overweight or Obesity is an Unfavorable Long-Term Prognostic Factor for Patients Who Underwent Gastrectomy for Stage II/III Gastric Cancer. World Journal of Surgery, 2019.\u003c/li\u003e\n\u003cli\u003eShimada S, Sawada N, Ishiyama Y, et al. Impact of obesity on short- and long-term outcomes of laparoscopy assisted distal gastrectomy for gastric cancer. Surg Endosc, 2018, 32: 358-366.\u003c/li\u003e\n\u003cli\u003eStruecker B, Biebl M, Dadras M, et al. The Impact of Obesity on Outcomes Following Resection for Gastric Cancer. Dig Surg, 2017, 34: 133-141.\u003c/li\u003e\n\u003cli\u003eHasbahcecI M, MehdI E, Malya F U, et al. Role of obesity and abdominal shape morphometric features to predict postoperative complications and quality of lymph node dissection of gastrectomy for gastric cancer. Neoplasma, 2017, 64: 922-932.\u003c/li\u003e\n\u003cli\u003eWang W, Ai KX, Tao F, et al. Impact of Abdominal Shape on Short-Term Surgical Outcome of Laparoscopy-Assisted Distal Gastrectomy for Gastric Cancer. J. Gastrointest. Surg, 2016, 20: 1091-7.\u003c/li\u003e\n\u003cli\u003eOjima T, Iwahashi M, Nakamori M, et al. The impact of abdominal shape index of patients on laparoscopy-assisted distal gastrectomy for early gastric cancer. Langenbecks Arch Surg, 2012, 397: 437-45.\u003c/li\u003e\n\u003cli\u003eChinese Medical Association. Laparoscopic surgical guideline for Gastric Carcinoma. (2007 Version). J Surg Concepts Pract 2007.12:610-614.\u003c/li\u003e\n\u003cli\u003eDaniel Dindo. The Clavien\u0026ndash;Dindo Classification of Surgical Complications.Treatment of Postoperative Complications After Digestive Surgery. 2014.\u003c/li\u003e\n\u003cli\u003eHiki N, Fukunaga T, Yamaguchi T, et al. Increased fat content and body shape have little effect on the accuracy of lymph node retrieval and blood loss in laparoscopic distal gastrectomy for gastric cancer. J. Gastrointest. Surg. 2009, 13: 626-33.\u003c/li\u003e\n\u003cli\u003eWu XS, Wu WG, Li ML, et al. Impact of being overweight on the surgical outcomes of patients with gastric cancer: a meta-analysis. World J. Gastroenterol. 2013, 19: 4596-606.\u003c/li\u003e\n\u003cli\u003eBickenbach KA, Denton B, Gonen M, et al. Impact of obesity on perioperative complications and long-term survival of patients with gastric cancer. Ann. Surg. Oncol, 2013, 20: 780-7.\u003c/li\u003e\n\u003cli\u003eLee JH, Paik YH, Lee JS, et al. Abdominal shape of gastric cancer patients influences short-term surgical outcomes. Ann. Surg. Oncol. 2007, 14: 1288-94.\u003c/li\u003e\n\u003cli\u003eRyu KW, Kim YW, Lee JH, et al. Surgical complications and the risk factors of laparoscopy-assisted distal gastrectomy in early gastric cancer. Ann. Surg. Oncol, 2008, 15: 1625-31.\u003c/li\u003e\n\u003cli\u003eKitano S, Shiraishi N, Uyama I, et al. A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann. Surg, 2007, 245: 68-72.\u003c/li\u003e\n\u003cli\u003eSugisawa N, Tokunaga M, Tanizawa Y, et al. Intra-abdominal infectious complications following gastrectomy in patients with excessive visceral fat. Gastric Cancer, 2012, 15: 206-12.\u003c/li\u003e\n\u003cli\u003eTakeuchi M, Ishii K, Seki H, et al. Excessive visceral fat area as a risk factor for early postoperative complications of total gastrectomy for gastric cancer: a retrospective cohort study. BMC Surg, 2016, 16: 54.\u003c/li\u003e\n\u003cli\u003eVuong B, Graff BAN, Dehal A, et al. Survival Analysis with Extended Lymphadenectomy for Gastric Cancer: Removing Stage Migration from the Equation. Am Surg, 2017, 83: 1074-1079.\u003c/li\u003e\n\u003cli\u003eBiondi A, D'Ugo D, Cananzi F C M et al. Does a minimum number of 16 retrieved nodes affect survival in curatively resected gastric cancer? Eur J Surg Oncol, 2015, 41: 779-86.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Abdominal shape, Gastric cancer, Laparoscopy-assisted distal gastrectomy, Short-term surgical outcome","lastPublishedDoi":"10.21203/rs.3.rs-84004/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-84004/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground \u003c/strong\u003e\u003c/p\u003e\u003cp\u003eThe surgery of laparoscopic distal gastrectomy + D2 lymph node dissection (LADG) is widely used in patients with gastric cancer, the purpose of the study is to explore the effect of abdominal shape on short-term surgical outcomes.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eMethods \u003c/strong\u003e\u003c/p\u003e\u003cp\u003eThis was a retrospective study which included 316 patients undergoing LADG from January 2013 to June 2019 at a single clinical center. The abdominal parameters including the shortest distance of the pancreas from the anterior abdominal skin (PAAD), the lower sternum angle (LSA), the thickness of subcutaneous fat at the navel level (SFT), the anteroposterior diameters (APD) and left-right diameters(LRD) at the navel level, the distance from xiphoid process to the navel (XND), and the distance from xiphoid process to the pubis (XBD) were calculated by preoperative abdominal computed tomography (CT) image. The parameters and short-term surgical outcomes were analyzed.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eResults \u003c/strong\u003e\u003c/p\u003e\u003cp\u003eIn males, the number of retrieved lymph nodes was significantly higher in patients with BMI \u0026lt;25kg/m2 (p=0.023) and APD \u0026lt;176.2mm (p=0.004). The time of operation was significantly shorter in male patients with BMI \u0026lt;25kg/m2(p=0.001), PAAD \u0026lt;64.6mm(p=0.000), SFT \u0026lt;14.9mm(p=0.017), APD \u0026lt;176.2mm(p=0.002) and LRD \u0026lt;290.0mm(p=0.036), and in female patients with XBD \u0026gt;370.0mm(p=0.042). The estimated blood loss was significantly lower in male patients with LSA \u0026lt;83.8° (p=0.009), PAAD \u0026lt;64.6mm(p=0.001), SFT \u0026lt;14.9mm(p=0.001), APD \u0026lt;176.2mm(p=0.009) and LRD \u0026lt;290.0mm(p=0.011). The complications were fewer in male patients with PAAD \u0026lt;64.6mm(p=0.045) and APD \u0026lt;176.2mm(p=0.011), and in female patients with LRD \u0026lt;288.5mm(p=0.047).\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConclusion \u003c/strong\u003e\u003c/p\u003e\u003cp\u003eVarious abdominal shapes can influence the difficulty of LADG. Lower LSA and PAAD can reduce the difficulty of LADG in male patients.\u003c/p\u003e","manuscriptTitle":"The Shortest Distance from the Skin to Pancreas and the Lower Sternum Angle can Influence Short-Term Surgical Outcomes of Laparoscopy-Assisted Distal Gastrectomy for Gastric Cancer","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2020-10-02 14:44:40","doi":"10.21203/rs.3.rs-84004/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2fb1db01-2ac8-480c-8a22-26f8f9198f29","owner":[],"postedDate":"October 2nd, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":664197,"name":"Gastrointestinal Surgery"},{"id":664198,"name":"Oncology"}],"tags":[],"updatedAt":"2020-11-28T13:07:42+00:00","versionOfRecord":[],"versionCreatedAt":"2020-10-02 14:44:40","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-84004","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-84004","identity":"rs-84004","version":["v1"]},"buildId":"oE6Zbj460LM0Up2FdVbMZ","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}