Visceral fat-to-muscle ratio is associated with inflammatory ileus after small intestinal fistula resection in sarcopenic patients with severe abdominal adhesions
10.16151/j.1007-810x.2025.01.006
- VernacularTitle:肠瘘合并肌少症病人内脏脂肪面积和腹肌面积指数比对术后肠功能恢复的影响
- Author:
Jing LI
1
;
Min CHEN
;
Yun-Li MA
Author Information
1. 东部战区总医院普通外科,江苏 南京 210002
- Keywords:
Postoperative ileus;
Body composition;
Sarcopenia;
Abdominal surgery
- From:
Parenteral & Enteral Nutrition
2025;32(1):35-41
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Postoperative inflammatory ileus(PII)is characterized by prolonged re-obstruction following temporary defecation after surgery.Small intestinal fistula resection(SIFE)in patients with severe abdominal adhesions may increase the risk of PII,particularly in those with oligomyosis.The ratio of visceral fat area(VFA)to total abdominal muscle area index(TAMAI)is thought to be associated with chronic inflammation and may negatively impact the recovery of intestinal motility after abdominal surgery.This study aims to evaluate the predictive value of VFA/TAMAI for postoperative PII in patients undergoing SIFE.Methods:Sarcopenic patients who underwent SIFE at Jinling Hospital between January 2016 and October 2022 were enrolled.Preoperative and intraoperative characteristics were analyzed.VFA/TAMAI was assessed as a potential risk factor for PII using regression analysis.Results:A total of 132 eligible patients(79 males[59.8%])with a median age of 52 years(interquartile range[IQR]:39～61 years)were included.Of these,18.2%(n=24)developed PII.Temporary defecation occurred 4 days after SIFE(IQR:2～5 days)and lasted for 2 days(IQR:1～2 days).Re-obstruction persisted for a median duration of 21 days(IQR:19～27 days)after temporary defecation.VFA/TAMAI was significantly associated with PII(OR=3.89,95%CI:1.88～7.92,P<0.001)and recovery of digestive tract function(HR=0.81,95%CI:0.65～0.99,P=0.04).Conclusion:VFA/TAMAI is associated with postoperative PII in sarcopenic patients with severe abdominal adhesions following SIFE.
