吴和, 周崇俊, 程一帆, 陈敏远, 陈邦飞. 内脏肥胖对中低位直肠癌根治术后近期疗效的影响[J]. 中国肿瘤临床, 2019, 46(16): 827-831. DOI: 10.3969/j.issn.1000-8179.2019.16.614
引用本文: 吴和, 周崇俊, 程一帆, 陈敏远, 陈邦飞. 内脏肥胖对中低位直肠癌根治术后近期疗效的影响[J]. 中国肿瘤临床, 2019, 46(16): 827-831. DOI: 10.3969/j.issn.1000-8179.2019.16.614
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Wu He, Zhou Chongjun, Cheng Yifan, Chen Minyuan, Chen Bangfei. Impact of visceral obesity on the short-term outcomes after radical operation for midlow rectal cancers[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2019, 46(16): 827-831. DOI: 10.3969/j.issn.1000-8179.2019.16.614
Citation: Wu He, Zhou Chongjun, Cheng Yifan, Chen Minyuan, Chen Bangfei. Impact of visceral obesity on the short-term outcomes after radical operation for midlow rectal cancers[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2019, 46(16): 827-831. DOI: 10.3969/j.issn.1000-8179.2019.16.614
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内脏肥胖对中低位直肠癌根治术后近期疗效的影响

Impact of visceral obesity on the short-term outcomes after radical operation for midlow rectal cancers

    摘要
  • 摘要:
      目的  探讨内脏肥胖对中低位直肠癌根治术后近期疗效的影响。
      方法  收集2017年4月至2018年10月在温州医科大学附属第二医院接受择期手术治疗的中低位直肠癌患者。根据内脏脂肪面积（visceral fat area，VFA），将男性≥ 134.6 cm2、女性≥ 91.1 cm作为定义内脏肥胖的标准，将患者分为内脏肥胖组和非内脏肥胖组。
      结果  127例患者符合纳入标准，包括64位内脏肥胖患者和63位非内脏肥胖组患者。和非内脏肥胖组相比，内脏肥胖组的女性比例更高（P=0.001）、BMI更高（P < 0.001）、开腹的比例更高（P=0.001）。两组患者在年龄、白蛋白、血红蛋白、ASA分级、NRS2002营养评分、Charlson合并症指数、肿瘤位置、TNM分期、淋巴结清扫数目以及手术持续时间等方面无显著性差异。内脏肥胖组的术后并发症发病率明显比非内脏肥胖组高（35.9% vs.19.0%，P=0.033）。多因素分析结果显示，内脏肥胖（OR=2.732，P=0.019）和NRS2002 ≥ 3（OR=2.574，P=0.042）为术后并发症的独立危险因素。
      结论  内脏肥胖是中低位直肠癌根治术后并发症的独立危险因素。

     

    Abstract:
      Objective  To investigate the effect of visceral obesity on the short-term outcomes after radical operation for mid-low rectal cancers.
      Methods  We conducted a prospective study on patients who underwent selective rectal cancer resection at The Second Affiliated Hospital of Wenzhou Medical University between April 2017 and October 2018. The cutoff visceral fat area (VFA) for visceral obesity was ≥ 134.6 cm2 for men and ≥ 91.1 cm2 for women.
      Results  A total of 127 patients were included in the study, of whom 64 were diagnosed as having visceral obesity and 63 as having non-visceral obesity. The patients with visceral obesity had a higher body mass index (BMI) (P < 0.001) than those without visceral obesity. The proportions of female patients and those who had a laparoscopy-assisted surgery were higher in the visceral obesity group than in the non-visceral obesity group. We found no significant differences in age, albumin level, hemoglobin count, American Society of Anesthesiologists (ASA) stage, Nutritional Risk Screening (NRS) 2002 score, Charlson comorbidity index, tumor location, TNM stage, lymphatic invasion, and laparoscopy-assisted surgery between the two groups. The postoperative complication rate was significantly higher in the visceral obesity group than in the non-visceral obesity group (35.9% vs. 19%, P=0.033). A multivariate Logistic regression analysis revealed that visceral obesityodds ratio (OR)=2.732, P=0.019 and NRS 2002 scores of ≥ 3 (OR=2.574, P=0.042) were independent risk factors for postoperative complications.
      Conclusions  Visceral obesity was an independent risk factor for complications after surgery for mid-low rectal cancers.

     

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