Li Wen-Feng, Que Chang-Rong, Xu Dong-Bo, Li Ping
Department of Gastrointestinal and Anus Surgery, The Affiliated Longyan First Hospital of Fujian Medical University, Longyan 364000, Fujian Province, China.
Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350000, Fujian Province, China.
World J Gastroenterol. 2025 Jun 14;31(22):105201. doi: 10.3748/wjg.v31.i22.105201.
The annual incidence of gastric cancer in elderly patients is increasing. Despite the continuous progress in treatment methods, the prognosis of elderly patients remains poor, and postoperative complications are frequent. Obesity is believed to be associated with the risk of gastric cancer and postoperative prognosis; however, the effect of visceral fat distribution on postoperative complications of gastric cancer in elderly patients remains unclear.
To explore the effect of visceral fat distribution on postoperative complications of gastric cancer in elderly patients.
A total of 163 elderly patients treated at the Affiliated Longyan First Hospital of Fujian Medical University after radical gastrectomy between January 2021 and January 2024 were enrolled. The patients' visceral and subcutaneous fat distributions were measured and divided into a high visceral fat area (VFA-H) group and a low visceral fat area (VFA-L) group, with a critical value of 100 cm. The -test and test were used to calculate and analyze the relationship between visceral fat area (VFA) and complications. Independent risk factors for postoperative complications were analyzed using binary logistic regression analysis.
Compared with the VFA-L group, the incidence of postoperative complications was higher in the VFA-H group (27.8% 6.4%, < 0.001), and the operation time was longer (268.55 ± 63.41 224.31 ± 51.89, < 0.001). The amount of blood loss was more (163.77 ± 105.27 mL 127.93 ± 98.26 mL, < 0.001). Logistic regression analysis showed that VFA [odds ratio (OR): 2.597, 95%CI: 1.479-4.853, = 0.004], total fat area (OR: 1.655, 95%CI: 1.076-4.040, = 0.013), and the visceral subcutaneous fat area ratio (OR: 2.046, 95%CI: 1.196-5.640, = 0.008) were independent risk factors for postoperative complications.
This study showed that postoperative complications are closely related to fat distribution in elderly patients with gastric cancer undergoing gastrectomy. A high VFA is associated by a high incidence of postoperative complications.
老年患者胃癌的年发病率正在上升。尽管治疗方法不断进步,但老年患者的预后仍然很差,术后并发症频繁。肥胖被认为与胃癌风险及术后预后相关;然而,内脏脂肪分布对老年胃癌患者术后并发症的影响仍不明确。
探讨内脏脂肪分布对老年胃癌患者术后并发症的影响。
选取2021年1月至2024年1月在福建医科大学附属龙岩第一医院接受根治性胃切除术后的163例老年患者。测量患者的内脏和皮下脂肪分布,并分为高内脏脂肪面积(VFA-H)组和低内脏脂肪面积(VFA-L)组,临界值为100 cm²。采用t检验和χ²检验计算并分析内脏脂肪面积(VFA)与并发症之间的关系。使用二元逻辑回归分析术后并发症的独立危险因素。
与VFA-L组相比,VFA-H组术后并发症发生率更高(27.8% vs 6.4%,P<0.001),手术时间更长(268.55±63.41 vs 224.31±51.89,P<0.001),失血量更多(163.77±105.27 mL vs 127.93±98.26 mL,P<0.001)。逻辑回归分析显示,VFA[比值比(OR):2.597,95%置信区间(CI):1.479-4.853,P=0.004]、总脂肪面积(OR:1.655,95%CI:1.076-4.040,P=0.013)和内脏皮下脂肪面积比(OR:2.046,95%CI:1.196-5.640,P=0.008)是术后并发症的独立危险因素。
本研究表明,老年胃癌根治性切除患者术后并发症与脂肪分布密切相关。高VFA与术后并发症的高发生率相关。