The Effect Of Visceral Fat Area On The Outcome Of Laparoscopic Colon Cancer Surgery And The Surgical Choice Of Patients With Visceral Obesity

?Background and purpose?Colon cancer is a common clinical malignant tumor of the digestive tract.With the development of society,people's lifestyle changes,their incidence rate has gradually increased.At present,the main method for the treatment of colon cancer is surgical treatment,but the occurrence of postoperative complications affects the patient's postoperative recovery and even threatens the patient's life.How to reduce or avoid the occurrence of postoperative complications has been a topic of concern for clinicians.In recent years,obesity has been considered as one of the non-surgical causes of long hospital stay after adverse events and colorectal surgery.^[1].However,the effect of visceral obesity on the surgical outcome of radical resection of laparoscopic colon cancer is still unclear.This article intends to retrospectively analyze the medical records of patients with colon cancer in our hospital to explore the relationship between visceral obesity and surgical outcomes of radical resection of laparoscopic colon cancer,and whether the implementation of endoscopy in visceral obesity is feasible.?Information and Methods?We selected 232 patients undergoing laparoscopic radical resection of colon cancer from our hospital during the period of 2016.01.01 to 2017.12.31 as the study subjects,and we obtained images of patients undergoing total abdominal CT in our hospital.Select the L4-L5 level of the CT cross-sectional image,the default fat's CT value is-190HU to-30HU,adjust the window width to 160,the window position to-110,get the whole fat distribution image of this cross-section,later use Image-Pro Plus 6.0 software processed these images to obtain subcutaneous fat and visceral fat coloring images,and then calculated subcutaneous fat area?SFA?and visceral fat area?VFA?values.VFA?100cm²was defined as visceral obesity group and VFA<100 cm² was defined as visceral non-obesity group.The preoperative and postoperative intraoperative and postoperative medical records of the two groups were analyzed and compared to observe VFA and body mass index(The relationship between BMI and VFA was correlated with intraoperative and postoperative outcomes,and factors with significant differences were selected for logistic multiple regression analysis to obtain independent risk factors that could predict postoperative complications;Patients with visceral obesity who underwent conventional radical resection of colon cancer undergoing endoscopic surgery for visceral obesity were divided into open and endoscopic groups to observe the differences between preoperative general data and surgical outcomes.?Result??1?The total number of patients undergoing radical resection of colon cancer under laparoscopy was 232,with an average age of 59.38±11.463 years:147 males;85 females;1.73:1 male to female ratio;?2?visceral obesity group Age,gender,preoperative albumin levels,tumor size,tumor location,depth of invasion,differentiation,vascular cancer emboli,nerve aggression,intraoperative blood loss,laparotomy,postoperative vent time,and visceral non-obesity There was no significant difference between the two groups?P>0.05?.Diabetes mellitus,hypertension,hypercholesterolemia,BMI,number of lymph nodes detected,postoperative hospital stay,total postoperative complications,and visceral obesity There was a statistically significant difference between the non-obese and visceral groups?P<0.05?.?3?There was a correlation between BMI and VFA?r=0.591?through scatter plots and Pearson correlation coefficient analysis;?4?through Logistic Multivariate regression analysis showed that age?65 years and VFA?100cm² was an independent risk factor for postoperative total complications,postoperative anastomotic leakage and postoperative surgical incision infection in patients undergoing radical resection of laparoscopic colon cancer.The difference was statistically significant?P<0.05?;?5?Laparoscopic group patient post operation hospitalization duration time set shorter than an open,less bleeding,,lower the incidence of surgical wound infection,and the difference was statistically significant?P<0.05?.?Conclusion?1.There is a positive correlation between BMI and VFA,but for the occurrence of postoperative complications,VFA has a better predictive ability than BMI.2.Patients with visceral obesity have a smaller number of lymph nodes detected and a longer hospital stay after radical laparoscopic radical resection of colon cancer than patients with non-visceral obesity;total complications after surgery,anastomotic leakage the incision infection after surgery,age?65 years,VFA?100cm ² is an independent predictor of its occurrence.3.For patients with visceral obesity,performing laparoscopic surgery does not significantly increase the intraoperative and short-term postoperative adverse outcomes.It is feasible to perform laparoscopic surgery for obese patients.