Tsukada Katsuhiko, Miyazaki Tatsuya, Kato Hiroyuki, Masuda Norihiro, Fukuchi Minoru, Fukai Yasuyuki, Nakajima Masanobu, Ishizaki Masatoshi, Motegi Masahiko, Mogi Akira, Sohda Makoto, Moteki Takao, Sekine Tomoaki, Kuwano Hiroyuki
Department of first Surgery, Gunma University School of Medicine, Maebashi, Japan.
Am Surg. 2004 Apr;70(4):347-51.
The contribution of subcutaneous or intra-abdominal fat (SCF, IAF) accumulation to postoperative mortality or morbidity after elective gastric or colorectal cancer surgery was studied. One hundred thirty-nine patients who underwent gastric or colorectal cancer surgery were investigated. Data were collected on the following preoperative comorbid conditions: lung dysfunction, cardiovascular dysfunction, liver dysfunction, or diabetes mellitus (DM). The IAF and SCF areas were determined at the umbilical level by preoperative CT scanning. We investigated whether IAF or SCF was independently associated with postoperative mortality or morbidity. The mortality rate was 0.7 per cent (1/139). Nineteen (14%) of 139 patients had medical complications (pneumonitis or arrhythmia) and 27 (19%) had surgery-related complications (anastomotic leakage, intra-abdominal collections, or abdominal wound infection) postoperatively. Age (> or =70 years), lung dysfunction, cardiovascular dysfunction, and IAF were significantly associated with medical complications, and surgical site (gastric/colorectal), DM, body mass index, IAF, and SCF were significant for surgery-related complications by univariate analysis. Multilogistic regression analysis showed that age, cardiovascular dysfunction, and IAF were significant for medical complications, and surgical site, DM, and SCF were independently related with surgery-related complications. Body fat accumulation is independently associated with postoperative morbidity after gastric or colorectal surgery, and assaying it may be useful for predicting postoperative complications.
研究了皮下或腹内脂肪（SCF、IAF）蓄积对择期胃癌或结直肠癌手术后死亡率或发病率的影响。对139例行胃癌或结直肠癌手术的患者进行了调查。收集了以下术前合并症的数据：肺功能障碍、心血管功能障碍、肝功能障碍或糖尿病（DM）。术前通过CT扫描在脐水平测定IAF和SCF面积。我们研究了IAF或SCF是否与术后死亡率或发病率独立相关。死亡率为0.7%（1/139）。139例患者中有19例（14%）出现内科并发症（肺炎或心律失常），27例（19%）术后出现手术相关并发症（吻合口漏、腹腔积液或腹部伤口感染）。单因素分析显示，年龄（≥70岁）、肺功能障碍、心血管功能障碍和IAF与内科并发症显著相关，手术部位（胃/结直肠）、DM、体重指数、IAF和SCF与手术相关并发症显著相关。多因素逻辑回归分析显示，年龄、心血管功能障碍和IAF与内科并发症显著相关，手术部位、DM和SCF与手术相关并发症独立相关。体脂蓄积与胃癌或结直肠癌手术后的术后发病率独立相关，对其进行检测可能有助于预测术后并发症。
