| Objective:To explore the influence of visceral obesity-related indicators and body mass index on laparoscopic surgical outcomes for colorectal cancer,and compare their differences to evaluates which index is more comprehensive and accurate,so as to improve the surgical program before surgery,ensure the smooth operation and improve the prognosis of patients.Methods:Inpatients undergoing laparoscopic colorectal cancer surgery in shaanxi provincial people’s hospital from May 2018 to December 2018 were selected as the study subjects.A total of 200 cases were selected,including 112 males and 88 females aged 32to 93 years(mean age 65.27±12.36 years).Preoperative collecting entrants in general clinical data,including the patient’s hospital number,name,gender,age,height,weight,preoperative have high blood pressure,diabetes,coronary heart disease and other important complications,smoking history,history of abdominal surgery,measurement in patients with waist circumference,hip circumference,BMI calculation patients,and by multislice CT(MSCT)of 200 columns on scanning,measuring the visceral fat area(VFA),subcutaneous fat area(SFA),according to the visceral fat area is greater than or equal to 100 cm~2 as criterion of visceral obesity,200 cases can be divided into two groups,high VFA group 68 examples,low VFA group 132 cases.According to the standard of BMI greater than or equal to 25kg/m~2,another 200 cases were divided into two groups,50 cases in the high BMI group and 150 cases in the low BMI group,divide forty-one patients into two groups with VFA and BMI.29 patients with high VFA and low BMI had VFA≥100cm~2 and BMI<25kg/m~2.There were 12 cases in the low VFA and high BMI group with VFA<100cm~2 and BMI≥25kg/m~2.After the surgery,the tumor differentiation,tumor stage,operation mode,operation time,intraoperative blood loss,number of intraoperative lymph node dissection,postoperative first exhaust time,postoperative fever time,postoperative complications,hospitalization time,hospitalization cost and other data were collected.General data and surgical outcomes were compared between the high VFA group and the low VFA group,and between the high BMI group and the low BMI group.Correlation between VFA and BMI and surgical outcomes were compared,and then regression analysis of complications was performed.In addition,visceral fat volume(VFV)and subcutaneous fat volume(SFV)of57 eligible patients were measured to compare the correlation between VFV and VFA and the outcomes of laparoscopic colon cancer surgery.Results:1.The differences in BMI(χ~2=54.856,P<0.05),waist circumference(t=16.708,P<0.05),hypertension(χ~2=5.077,P<0.05)and coronary heart disease(χ~2=11.459,P<0.05)in the high VFA group and the low VFA group were statistically significant.2.Compared with general data of the low BMI group,VFA(χ~2=52.406,P<0.05)and waist circumference(t=9.973,P<0.05)showed statistically significant differences between the high BMI group and the low BMI group.3.Compared with the surgical outcomes of the low VFA group,the operation time(t=9.178,P<0.05),intraoperative blood loss(t=22.182,P<0.05),first exhaust time(t=2.399,P<0.05),average hospitalization cost(t=3.775,P<0.05)and the incidence of postoperative intestinal obstruction(χ~2=4.529,P<0.05)in the high VFA group were all higher than those in the low VFA group.4.Compared with the surgical outcomes of the low BMI group,the operation time(t=4.355,P<0.05)and intraoperative blood loss(t=9.070,P<0.05)in the high BMI group were higher than those in the low BMI group.5.The mean operative time(t=3.249,P<0.05),intraoperative blood loss(t=8.009,P<0.05)and hospitalization cost(t=2.283,P<0.05)in the high VFA and low BMI groups were higher than those in the low VFA and high BMI groups.6.VFA,BMI and the multiple linear regression analysis results show that the VFV,VFA and VFV standard regression coefficient was 0.723(P<0.05),explain VFA is linear positive correlation with the VFV difference was statistically significant(P<0.05),and BMI and VFV standard regression coefficient was 0.088(P>0.05),no obvious linear correlation between BMI and VFV.7.Linear regression analysis of VFA and VFV showed that there was a positive linear correlation between VFA and VFV,and the standard regression coefficient was0.779,(P<0.05).8.Correlation analysis between VFV and surgical outcomes showed that VFV was positively correlated with operative time(r=0.409,P<0.05)and intraoperative blood loss(r=0.683,P<0.05).9.Correlation analysis of VFA and surgical outcomes showed that VFA was positively correlated with operative time(r=0.439,P<0.05),intraoperative blood loss(r=0.564,P<0.05),postoperative first exhaust time(r=0.219,P<0.05),and hospitalization cost(r=0.237,P<0.05).10.Correlation analysis of BMI and surgical outcomes showed that BMI was positively correlated with surgical duration(r=0.331,P<0.05)and intraoperative blood loss(r=0.596,P<0.05).11.Logistic regression analysis of postoperative complications showed that neither VFA nor BMI were risk factors for postoperative complications(P>0.05).12.Logistic regression analysis of postoperative ileus complications showed that VFA was an independent risk factor for postoperative ileus complications,with a risk of6.665(regression coefficient of 1.897,P<0.05).Conclusion:1.There is a strong linear positive correlation between VFA and VFV.When VFV cannot be measured,VFA can be used to better predict VFV.2.Compared with non-visceral obese patients,laparoscopic surgery for colorectal cancer takes longer,the intraoperative blood loss is higher,the postoperative first exhaust time is later,the hospitalization cost is higher,and the postoperative complication rate of intestinal obstruction is higher.3.Compared with patients with lower body mass index,patients with high body mass index had longer operation time and more intraoperative blood loss in laparoscopic colorectal cancer surgery.4.visceral obesity indexes may be more comprehensive and accurate in evaluating the content of visceral fat in the body mass index,and the effect of laparoscopic colorectal cancer surgery is greater. |
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