The effect of abdominal visceral fat area on perioperative complications and pancreatic fistula in primary gastric carcinoma patients after laparoscopic assisted radical gastrectomy
10.3760/cma.j.cn113855-20220618-00397
- VernacularTitle:腹部内脏脂肪面积对腹腔镜辅助胃癌根治术后围手术期并发症及临床相关胰瘘的影响
- Author:
Qing TIAN
1
;
Xiaolin HU
;
Shijiang LIU
;
Huiming LIU
;
Kai LIU
;
Yong FENG
Author Information
1. 寿光市人民医院肝胆胃肠科，潍坊 262700
- Keywords:
Stomach neoplasms;
Abdominal fat;
Pancreatic fistula;
Postoperative complications
- From:
Chinese Journal of General Surgery
2023;38(5):357-361
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the effect of visceral fat area (VFA) on postoperative complications and pancreatic fistula in patients undergoing laparoscopic assisted radical gastrectomy for gastric careinoma.Methods:Clnical data of 214 primary gastric cancer patients undergoing laparoscopic assisted radical gastrectomy between Jan 2017 and Jan 2022 at the Department of General Surgery, Shouguang People's Hospital were retrospectively reviewed.Results:There were 85 patients in high VFA group and 129 patients in the low VFA group. The body mass index (25.1±3.4) kg/m 2 and visceral fat area (143.4±41.1) cm 2 in the high VFA group were higher than those in the low VFA group (21.2±2.9) kg/m 2 and visceral fat area (58.7±31.9) cm 2. The operative time was (228.3±53.1) min vs. (206.3±62.9) min ( t=5.538, P=0.017). The intraoperative blood loss was (264.6±173.6) ml vs. (213.9±156.2) ml ( t=3.373, P=0.035). The postoperative hospital stay was (12.5±4.0) d vs. (10.3±3.7) d ( t=7.781, P=0.013). Twenty-three cases developed postoperative complications in the high VFA group vs. 20 cases in the low VFA group ( χ2=4.261, P=0.039). Patients in the high VFA group had an incidence of clinically relevant pancreatic fistula of 10.6% vs. 3.1% in patients in the low VFA group ( χ2=5.034, P=0.038). Univariate and multivariate analysis of clinically relevant pancreatic fistulas in patients with different VFA groups showed that men ≥134.6 cm 2 and women ≥91.1 cm 2 with VFA and operative time ≥250 min were independent risk factors for the occurence of clinically relevant pancreatic fistulas after laparoscopic assisted radical gastrectomy. Conclusions:VFA increases the difficulty of laparoscopic-assisted radical gastrectomy, resulting in increased postoperative complications. VFA and operation time are independent risk factors for clinically relevant pancreatic fistula after radical gastrectomy for gastric cancer.
