Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
PeerJ. 2023 Apr 19;11:e15156. doi: 10.7717/peerj.15156. eCollection 2023.
Intra-abdominal fat volume (IFV) has been shown to have a negative impact on surgical outcomes in gastric cancer (GC) and other gastrointestinal surgeries. The purpose of this study is to look into the relationship between IFV and perioperative outcomes in GC patients using multi-detector rows computed tomography (MDCT) and assess the importance of implementing this observation in current surgical fellowship training programs.
Patients with GC who underwent open D2 gastrectomy between May 2015 and September 2017 were included in the study. Based on MDCT estimation, patients were divided into high IFV (IFV ≥ 3,000 ml) and low IFV (IFV < 3,000 ml) groups. Perioperative outcomes for cancer staging, type of gastrectomy, intraoperative blood loss (IBL), anastomotic leakage, and hospital stay were compared between the two groups. This study was registered as CTR2200059886.
Out of 226 patients, 54 had early gastric carcinoma (EGC), while 172 had advanced gastric carcinoma (AGC). There were 64 patients in the high IFV group and 162 in the low IFV group. The high IFV group had significantly higher IBL mean values ( = 0.008). Therefore, having a high IFV was a risk factor for the occurrence of perioperative complications ( = 0.008).
High IFV estimated by MDCT prior to GC surgery was associated with increased IBL and postoperative complications. Incorporating this CT-IFV estimation into surgical fellowship programs may aid aspiring surgeons in selecting patients during independent practice in their learning curve and surgical practice for the most appropriate approach for treating GC patients.
腹腔内脂肪量（IFV）已被证明对胃癌（GC）和其他胃肠手术的手术结果有负面影响。本研究旨在通过多排螺旋 CT（MDCT）研究 IFV 与 GC 患者围手术期结果之间的关系，并评估在当前外科住院医师培训计划中实施这一观察的重要性。
纳入 2015 年 5 月至 2017 年 9 月期间接受开腹 D2 胃切除术的 GC 患者。根据 MDCT 估计，患者分为高 IFV（IFV≥3000ml）和低 IFV（IFV<3000ml）组。比较两组患者的癌症分期、胃切除术类型、术中出血量（IBL）、吻合口漏和住院时间等围手术期结果。本研究已在 CTR2200059886 注册。
226 例患者中，54 例为早期胃癌（EGC），172 例为进展期胃癌（AGC）。高 IFV 组 64 例，低 IFV 组 162 例。高 IFV 组的 IBL 平均值明显较高（ = 0.008）。因此，高 IFV 是围手术期并发症发生的危险因素（ = 0.008）。
GC 手术前 MDCT 估计的高 IFV 与术中出血量增加和术后并发症相关。将这种 CT-IFV 估计纳入外科住院医师培训计划可能有助于有抱负的外科医生在其学习曲线和手术实践中，在独立实践中选择患者，为 GC 患者选择最合适的治疗方法。
