Background
Methods
Patients
Evaluation of fat area
Statistical analysis
Results
Comparison of baseline characteristics
High-VFA (n = 26) | Low-VFA (n = 49) | p value | |
---|---|---|---|
Sex (men/women) | 22/4 | 35/14 | 0.20 |
Age (mean ± SD) | 70.8 ± 9.7 | 70.7 ± 10.2 | 0.71 |
ASA (I/II/III) | 7/15/4 | 6/36/7 | 0.25 |
BMI (kg/m2) in mean ± SD | 25.1 ± 3.0 (20.0–32.2) | 20.8 ± 2.6 (14.7–25.4) | <0.0001 |
VFA (cm2) (mean ± SD) | 146.9 ± 38.2 (101.8–240.9) | 54.3 ± 27.1 (5.9–99.9) | <0.0001 |
SFA (cm2) (mean ± SD) | 157.1 ± 54.8 (77.3–292.3) | 86.1 ± 54.9 (5.1–200.5) | <0.0001 |
Total fat area (cm2) (mean ± SD) | 304.0 ± 74.7 (194.7–481.2) | 140.5 ± 72.0 (14.3–286.0) | <0.0001 |
Diabetes mellitus | 7 | 7 | 0.18 |
Cardiac history | 5 | 8 | 0.75 |
Pulmonary history | 1 | 3 | 0.68 |
Chronic kidney disease | 4 | 0 | 0.005 |
Pathologic T (1a/1b/2/3/4a/4b) | 1/7/7/4/7/0 | 2/6/9/20/10/2 | 0.19 |
Pathologic N (0/1/2/3) | 12/4/3/7 | 17/6/13/13 | 0.48 |
Pathologic M (0/1) | 26/1 | 44/5 | 0.33 |
Pathologic stage (I/II/III/IV) | 11/6/8/1 | 14/10/20/5 | 0.51 |
Neoadjuvant chemotherapy | 0 | 3 | 0.198 |
Residual gastrectomy | 0 | 6 | 0.06 |
Splenectomy | 8 | 10 | 0.32 |
Resection of pancreatic tail | 1 | 2 | 0.24 |
Partial resection of colon | 1 | 1 | 0.64 |
Comparison of surgical outcomes and postoperative complications
High-VFA (n = 26) | Low-VFA (n = 49) | p value | |
---|---|---|---|
Number of retrieved lymph nodes (mean ± SD) | 42.7 ± 18.7 | 43.0 ± 24.2 | 0.81 |
Operating time (min) in mean ± SD | 225.9 ± 92.0 | 200.9 ± 58.3 | 0.08 |
Blood loss (ml) in mean ± SD | 467.9 ± 600.2 | 318.5 ± 407.1 | 0.32 |
Postoperative hospital stay (day) in mean ± SD | 22.8 ± 15.7 | 18.8 ± 9.6 | 0.70 |
Postoperative complications | |||
Cardiac | 0 | 3 | 0.20 |
Pneumonia | 4 | 4 | 0.33 |
Incisional SSI | 12 | 6 | 0.001 |
Ileus | 2 | 0 | 0.05 |
Anastomotic leakage | 6 | 3 | 0.03 |
Pancreatic fistula | 2 | 1 | 0.23 |
Abdominal abscess | 4 | 3 | 0.19 |
Postoperative hemorrhage | 1 | 2 | 0.96 |
Other | 4 | 5 | 0.53 |
Risk factors for anastomotic leakage and incisional SSI
Risk factors | anastomotic leakage (+) | anastomotic leakage (−) | Univariate analysis | Logistic regression analysis | |
---|---|---|---|---|---|
Hazard ratio (95 % CI) | p value | ||||
Sex | |||||
Men | 9 | 48 | 0.072 | ||
Women | 0 | 18 | |||
Age (mean ± SD) | 64.6 ± 7.5 | 71.6 ± 10.0 | 0.017 | 0.94 (0.87–1.01) | 0.057 |
ASA | |||||
I | 2 | 11 | 0.891 | ||
II | 6 | 45 | |||
III | 1 | 10 | |||
BMI (≥25/<25 kg/m2) | 4/5 | 12/54 | 0.071 | ||
VFA (≥100/<100 cm2) | 6/3 | 20/46 | 0.032 | 4.6 (1.05–20.25) | 0.044 |
SFA (cm2) (mean ± SD) | 126.5 ± 56.5 | 108.6 ± 65.3 | 0.434 | ||
Diabetes mellitus | 2 | 12 | 0.77 | ||
Cardiac history | 2 | 11 | 0.695 | ||
Pulmonary history | 0 | 4 | 0.444 | ||
Chronic kidney disease | 1 | 3 | 0.419 | ||
Pathologic Stage | |||||
I | 1 | 24 | 0.269 | ||
II | 3 | 13 | |||
III | 5 | 23 | |||
IV | 0 | 6 | |||
Neoadjuvant chemotherapy | 0 | 3 | 0.514 | ||
Residual gastrectomy | 0 | 6 | 0.346 | ||
Splenectomy | 2 | 16 | 0.894 | ||
Resection of pancreatic tail | 1 | 2 | 0.246 | ||
Partial resection of colon | 0 | 2 | 0.597 | ||
Number of retrieved lymph nodes (mean ± SD) | 38.4 ± 22.3 | 43.5 ± 22.4 | 0.487 | ||
Operating time (min) (mean ± SD) | 254.8 ± 118.8 | 207.3 ± 59.0 | 0.23 | ||
Blood loss (ml) (mean ± SD) | 572.5 ± 663.7 | 351.4 ± 460.2 | 0.428 |
Risk factors | anastomotic leakage (+) | anastomotic leakage (−) | β | SE | Hazard ratio (95 % CI) | p value |
---|---|---|---|---|---|---|
Age (≥70/<70 years) | 2/7 | 35/31 | −0.20 | 0.22 | 0.25 (0.05–1.36) | 0.108 |
VFA (≥100/<100 cm2) | 6/3 | 20/46 | 0.25 | 3.57 | 4.62 (1.02–21.02) | 0.048 |
Risk factors | Incisional SSI (+) | Incisional SSI (−) | Univariate analysis | Logistic regression analysis | |
---|---|---|---|---|---|
Hazard ratio (95 % CI) | p value | ||||
Sex | |||||
Men | 15 | 42 | 0.403 | ||
Women | 3 | 15 | |||
Age (years) | 71.2 ± 9.4 | 70.6 ± 10.2 | 0.98 | ||
ASA | |||||
I | 1 | 12 | 0.318 | ||
II | 14 | 37 | |||
III | 3 | 8 | |||
BMI (≥25/<25 kg/m2) | 8/10 | 8/49 | 0.006 | 4.9 (1.49–16.15) | 0.009 |
VFA (≥100/<100 cm2) | 12/6 | 14/43 | 0.001 | 6.14 (1.94–19.41) | 0.002 |
SFA (cm2) (mean ± SD) | 136.9 ± 73.3 | 102.5 ± 59.5 | 0.104 | ||
Diabetes mellitus | 3 | 11 | 0.803 | ||
Cardiac history | 5 | 8 | 0.144 | ||
Pulmonary history | 1 | 3 | 0.921 | ||
Chronic kidney disease | 2 | 2 | 0.186 | ||
Pathologic Stage | |||||
I | 6 | 19 | 0.527 | ||
II | 4 | 12 | |||
III | 8 | 20 | |||
IV | 0 | 6 | |||
Neoadjuvant chemotherapy | 1 | 2 | 0.699 | ||
Residual gastrectomy | 0 | 6 | 0.151 | ||
Splenectomy | 3 | 15 | 0.403 | ||
Resection of pancreatic tail | 1 | 2 | 0.699 | ||
Partial resection of colon | 1 | 1 | 0.383 | ||
Number of retrieved lymph nodes (mean ± SD) | 39.7 ± 18.2 | 43.9 ± 23.5 | 0.85 | ||
Operating time (min) (mean ± SD) | 225.1 ± 64.2 | 208.6 ± 69.6 | 0.278 | ||
Blood loss (ml) (mean ± SD) | 368.2 ± 369.9 | 377.4 ± 517.7 | 0.985 |
Risk factors | Incisional SSI (+) | Incisional SSI (−) | β | SE | Hazard ratio (95 % CI) | p value |
---|---|---|---|---|---|---|
BMI (≥25/<25 kg/m2) | 8/10 | 8/49 | 0.31 | 1.60 | 2.28 (0.57–9.04) | 0.241 |
VFA (≥100/<100 cm2) | 12/6 | 14/43 | 0.38 | 2.86 | 4.32 (1.18–15.80) | 0.027 |