Kim Ho Seung, Kim Kwang Ho, Noh Gyoung Tae, Lee Ryung-Ah, Chung Soon Sup
Department of Surgery, Ewha Womans University College of Medicine, Seoul, Korea.
Ann Coloproctol. 2023 Aug;39(4):342-350. doi: 10.3393/ac.2022.00262.0037. Epub 2022 Jun 3.
Obesity has been known to contribute to technical difficulties in surgery. Until now, body mass index (BMI) has been used to measure obesity. However, there are reports that BMI does not always correspond to the visceral fat. Recently, bioelectrical impedance analysis (BIA) has been used for body composition analysis. This study aimed to evaluate the usefulness of the body composition index obtained using a BIA device in predicting short-term postoperative outcomes.
Data of patients who underwent elective major colorectal surgery using minimally invasive techniques were reviewed retrospectively. Body composition status was recorded using a commercial BIA device the day before surgery. The relationship between BMI, body composition index, and short-term postoperative outcomes, including operative time, was analyzed.
Sixty-six patients were enrolled in this study. In the correlation analysis, positive correlation was observed between BMI and body composition index. BMI and body composition index were not associated with short-term postoperative outcomes. Percent body fat (odds ratio, 4.226; 95% confidence interval [CI], 1.064-16.780; P=0.041) was found to be a statistically significant factor of prolonged operative time in the multivariate analysis. Correlation analysis showed that body fat mass was related to prolonged operative time (correlation coefficients, 0.245; P=0.048). In the area under curve analysis, body fat mass showed a statistically significant predictive probability for prolonged operative time (body fat mass: area, 0.662; 95% CI, 0.531-0.764; P=0.024).
The body composition index can be used as a predictive marker for prolonged operative time. Further studies are needed to determine its usefulness.
肥胖已被证实会导致手术中的技术难题。到目前为止，体重指数（BMI）一直被用于衡量肥胖程度。然而，有报道称BMI并不总是与内脏脂肪相对应。最近，生物电阻抗分析（BIA）已被用于身体成分分析。本研究旨在评估使用BIA设备获得的身体成分指数在预测术后短期结果方面的有效性。
回顾性分析采用微创技术接受择期大肠大手术患者的数据。术前一天使用商用BIA设备记录身体成分状况。分析BMI、身体成分指数与包括手术时间在内的术后短期结果之间的关系。
本研究纳入了66例患者。在相关性分析中，观察到BMI与身体成分指数呈正相关。BMI和身体成分指数与术后短期结果无关。在多因素分析中，体脂百分比（优势比，4.226；95%置信区间[CI]，1.064 - 16.780；P = 0.041）被发现是手术时间延长的统计学显著因素。相关性分析表明，体脂量与手术时间延长有关（相关系数，0.245；P = 0.048）。在曲线下面积分析中，体脂量对手术时间延长显示出统计学显著的预测概率（体脂量：面积，0.662；95% CI，0.531 - 0.764；P = 0.024）。
身体成分指数可作为手术时间延长的预测标志物。需要进一步研究以确定其有效性。
