内脏脂肪过多对胃癌切除术患者围手术期的影响

Impact of visceral fat area on perioperative recovery after total gastrectomy for gastric cancer

摘要:

目的对比分析全胃切除术治疗内脏脂肪过多和正常内脏脂肪胃癌患者围手术期疗效，评估内脏脂肪对患者围手术期恢复的影响。方法回顾性分析2015年4月-2016年6 月该院普通外科65例胃癌患者的临床资料，根据患者术前CT计算的内脏脂肪面积分为内脏脂肪过多组（A组=30 例）和内脏脂肪正常组（B组=35 例），比较两组术前人口统计学资料、术中手术相关变量、术后并发症和死亡患者情况。结果A组术中失血量与B 组比较，差异有统计学意义（t =0.810， P=0.030）；A 组术后感染并发症率与B 组比较，差异有统计学意义（P =0.038）；A 组术后吻合口瘘发生率与B组比较，差异有统计学意义（P =0.042）；A组术后住院时间与B 组比较，差异有统计学意义（t =3.122，P =0.003）；两组患者术后其它并发症和死亡患者比较，差异无统计学意义（P >0.05）。结论内脏脂肪过多的患者术中失血量多，术后感染机会更高，吻合口瘘发生率高、术后住院时间更长。

关键词:内脏脂肪过多;胃癌;全胃切除术;恢复

Abstract:

Objective To compare the effect of visceral fat area (VFA) on perioperative recovery after total gastrectomy for gastric cancer between excessive VFA and normal VFA patients. Methods The clinical data of 65 patients with gastric carcinoma who underwent total gastrectomy from April 2015 to June 2016 in the Department of General Surgery of our hospital were retrospectively analyzed. The patients were divided into excessive VFA group (group A, 30 cases) and normal VFA group (group B, 35 cases) according to the visceral fat area acquired by preoperative CT scanning. The main observation index included preoperative demographic features, operation-related variables during surgery, postoperative complications and death. Results The intraoperative blood loss of the group A was more than that of the group B, the difference was statistically significant (t = 0.810, P= 0.030). The postoperative infection rate of the group A was statistically higher than that of the group B (t = 4.997,P = 0.038). The rate of anastomotic fistula in the group A was higher than that in the group B, the difference was statistically significant (t = 4.940,P = 0.042). The postoperative hospital stay of the group A was statistically longer than that of the group B (t = 3.122,P =0.003). There were no statistically differences between the two groups concerning other postoperative complications and the number of death (P > 0.05). Conclusions The patients with excessive visceral fat have more blood loss during total gastrectomy, higher risks of postoperative infection and anastomotic leakage, and longer postoperative hospital stay.

Key words:excessive visceral fat; gastric cancer; total gastrectomy; recovery