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老年结直肠癌患者内脏肥胖与术后结局的关联

The Association Between Visceral Obesity and Postoperative Outcomes in Elderly Patients With Colorectal Cancer.

作者信息

Dong Qiantong, Song Haonan, Chen Weizhe, Wang Wenbin, Ruan Xiaojiao, Xie Tingting, Huang Dongdong, Chen Xiaolei, Xing Chungen

机构信息

Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, China.

Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

出版信息

Front Surg. 2022 Jun 6;9:827481. doi: 10.3389/fsurg.2022.827481. eCollection 2022.

Abstract

BACKGROUND

The impact of visceral obesity on the postoperative complications of colorectal cancer in elderly patients has not been well studied. This study aims to explore the influence of visceral obesity on surgical outcomes in elderly patients who have accepted a radical surgery for colorectal cancer.

METHODS

Patients aged over 65 year who had undergone colorectal cancer resections from January 2015 to September 2020 were enrolled. Visceral obesity is typically evaluated based on visceral fat area (VFA) which is measured by computed tomography (CT) imaging. Univariate and multivariate analyses were performed to analyze parameters related to short-term outcomes.

RESULTS

A total of 528 patients participated in this prospective study. Patients with visceral obesity exhibited the higher incidence of total (34.1% vs. 18.0%, < 0.001), surgical (26.1% vs. 14.6%,  = 0.001) and medical (12.6% vs. 6.7%,  = 0.022) complications. Based on multivariate analysis, visceral obesity and preoperative poorly controlled hypoalbuminemia were considered as independent risk factors for postoperative complications in elderly patients after colorectal cancer surgery.

CONCLUSIONS

Visceral obesity, evaluated by VFA, was a crucial clinical predictor of short-term outcomes after colorectal cancer surgery in elderly patients. More attentions should be paid to these elderly patients before surgery.

摘要

背景

内脏肥胖对老年结直肠癌患者术后并发症的影响尚未得到充分研究。本研究旨在探讨内脏肥胖对接受结直肠癌根治性手术的老年患者手术结局的影响。

方法

纳入2015年1月至2020年9月期间接受结直肠癌切除术的65岁以上患者。内脏肥胖通常根据通过计算机断层扫描(CT)成像测量的内脏脂肪面积(VFA)进行评估。进行单因素和多因素分析以分析与短期结局相关的参数。

结果

共有528例患者参与了这项前瞻性研究。内脏肥胖患者的总体并发症(34.1%对18.0%,<0.001)、手术并发症(26.1%对14.6%,=0.001)和医疗并发症(12.6%对6.7%,=0.022)发生率更高。基于多因素分析,内脏肥胖和术前低白蛋白血症控制不佳被认为是老年结直肠癌患者术后并发症的独立危险因素。

结论

通过VFA评估的内脏肥胖是老年结直肠癌患者术后短期结局的关键临床预测指标。术前应更加关注这些老年患者。

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