Department of Cardiothoracic Surgery, Nanjing Yimin Hospital, Nanjing, China.
Department of Internal Medicine, Third People's Hospital of Lishui District, Nanjing, China.
J Int Med Res. 2024 Oct;52(10):3000605241282077. doi: 10.1177/03000605241282077.
We aimed to investigate the relationship between the visceral to subcutaneous fat area ratio (V/S ratio) and incidence of early postoperative small bowel obstruction (EPSBO) following total gastrectomy for cardia cancer.
We conducted a retrospective analysis among patients with cardia cancer who underwent elective total gastrectomy with esophagojejunostomy Roux-en-Y anastomosis at Nanjing Yimin Hospital between November 2019 and April 2024. Preoperative, intraoperative, and postoperative factors were meticulously monitored. The V/S ratio was calculated using computed tomography scans at the umbilical level with Slice-O-Matic software (Tomovision, Montreal, Canada). Statistical analyses included logistic regression and receiver operating characteristic (ROC) curve analysis.
Among 175 patients, 27 (15.4%) developed EPSBO. The V/S ratio was significantly higher in the EPSBO group (1.76 ± 1.05 vs. 1.01 ± 0.54). Logistic regression identified the V/S ratio as a significant predictor of EPSBO (odds ratio [OR] = 1.612, 95% [CI]: 1.102-1.605). ROC curve analysis demonstrated high sensitivity (92%) and specificity (100%) for the V/S ratio in predicting EPSBO, with a 0.83 AUC.
Our findings indicated a higher V/S ratio was a significant predictor of EPSBO following total gastrectomy for cardia cancer. Preoperative assessment of the V/S ratio can inform risk stratification and guide targeted interventions to improve postoperative outcomes.
本研究旨在探讨贲门癌全胃切除术后早期小肠梗阻（EPSBO）与内脏脂肪面积与皮下脂肪面积比值（V/S 比值）之间的关系。
回顾性分析 2019 年 11 月至 2024 年 4 月在南京益民医院行全胃切除、食管空肠 Roux-en-Y 吻合术的贲门癌患者的临床资料。仔细监测患者术前、术中及术后的相关因素。采用 Slice-O-Matic 软件（加拿大蒙特利尔的 Tomovision）计算脐水平 CT 扫描的 V/S 比值。统计学分析包括逻辑回归和受试者工作特征（ROC）曲线分析。
在 175 例患者中，27 例（15.4%）发生了 EPSBO。EPSBO 组的 V/S 比值明显高于非 EPSBO 组（1.76±1.05 比 1.01±0.54）。Logistic 回归分析发现 V/S 比值是 EPSBO 的显著预测因素（比值比 [OR] = 1.612，95%[CI]：1.102-1.605）。ROC 曲线分析表明 V/S 比值预测 EPSBO 的敏感性为 92%，特异性为 100%，曲线下面积为 0.83。
本研究表明，贲门癌全胃切除术后 V/S 比值升高是 EPSBO 的一个显著预测因素。术前评估 V/S 比值可以进行风险分层，并指导有针对性的干预措施，以改善术后结局。
