体质指数是腹腔镜肝癌切除术术后发病率的一个风险因素：一项多中心回顾性研究。
Body mass index is a risk factor for postoperative morbidity after laparoscopic hepatectomy of hepatocellular carcinoma: a multicenter retrospective study.
机构信息
Department of Comprehensive Surgery, Vascular Surgery, Nantong First People's Hospital, Affiliated Hospital 2 of Nantong University, Chongchuan District, 666 Shengli Road, Nantong City, 226014, Jiangsu Province, China.
Department of General Surgery, Nantong Second People's Hospital, 298 Xinhua Road, Gangzha District, Nantong City, 226002, Jiangsu Province, China.
出版信息
J Cancer Res Clin Oncol. 2024 Oct 5;150(10):445. doi: 10.1007/s00432-024-05979-w.
PURPOSE
The aim of this study was to determine whether preoperative body mass index (BMI) was associated with postoperative morbidity after laparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC).
METHODS
A total of three groups of patients were categorized based on preoperative BMI: low-BMI (≤ 18.4 kg/m), normal-BMI (18.5-24.9 kg/m) and high-BMI (≥ 25.0 kg/m). Baseline clinicopathological characteristics, operative variables, and postoperative 30-day mortality and morbidity were recorded and compared among the three groups. The independent risk factors for postoperative morbidity, including surgical site infection (SSI), were identified using univariate and multivariate analyses.
RESULTS
Among 226 included patients, 20 (8.8%), 122 (54%), and 84 (37.2%) patients had low, normal, and high BMI, respectively. There were no significant differences in postoperative 30-day mortality rates in patients with low BMI and high BMI compared with those with normal BMI (5% and 1.2% vs. 0%, P = 0.141 and P = 0.408, respectively). However, postoperative morbidity rates were significantly higher in patients with low BMI and high BMI compared to those with normal BMI (40% and 32.1% vs. 17.2%, P = 0.032 and P = 0.020, respectively). According to multivariate analysis, both low and high BMI were independent risk factors of increased postoperative morbidity (OR: 5.03, 95% CI: 1.02-25.6, P = 0.047, and OR: 4.53, 95% CI: 1.75-12.8, P = 0.003, respectively). Low and high BMI were also identified as independent risk factors of increased postoperative SSI rates (OR: 6.25, 95% CI: 1.60-23.8, P = 0.007, and OR: 2.89, 95% CI: 1.04-8.77, P = 0.047, respectively).
CONCLUSION
A higher incidence of postoperative morbidity including SSI after LLR for HCC was found in low-BMI and high-BMI patients compared to normal-BMI patients.
CLINICAL TRIALS REGISTRATION
Not applicable because this is a retrospective observational study.
目的
本研究旨在确定术前体重指数（BMI）是否与肝癌患者腹腔镜肝切除（LLR）后的术后发病率相关。
方法
根据术前 BMI 将三组患者分为低 BMI（≤18.4 kg/m）、正常 BMI（18.5-24.9 kg/m）和高 BMI（≥25.0 kg/m）。记录三组患者的基线临床病理特征、手术变量以及术后 30 天死亡率和发病率，并进行比较。采用单因素和多因素分析确定术后发病率（包括手术部位感染（SSI））的独立危险因素。
结果
在 226 名纳入患者中，分别有 20 名（8.8%）、122 名（54%）和 84 名（37.2%）患者的 BMI 较低、正常和较高。低 BMI 和高 BMI 患者的术后 30 天死亡率与正常 BMI 患者相比无显著差异（分别为 5%和 1.2%与 0%，P=0.141 和 P=0.408）。然而，低 BMI 和高 BMI 患者的术后发病率明显高于正常 BMI 患者（分别为 40%和 32.1%与 17.2%，P=0.032 和 P=0.020）。多因素分析显示，低 BMI 和高 BMI 均为术后发病率增加的独立危险因素（OR：5.03，95%CI：1.02-25.6，P=0.047，和 OR：4.53，95%CI：1.75-12.8，P=0.003）。低 BMI 和高 BMI 也被确定为术后 SSI 发生率增加的独立危险因素（OR：6.25，95%CI：1.60-23.8，P=0.007，和 OR：2.89，95%CI：1.04-8.77，P=0.047）。
结论
与正常 BMI 患者相比，肝癌患者腹腔镜肝切除术后低 BMI 和高 BMI 患者的术后发病率较高，包括 SSI。
临床试验注册
不适用，因为这是一项回顾性观察研究。
Zotero 插件