| Objective:Colorectal cancer is the third largest malignant tumor in the world.With the changes of diet habits and structure,the incidence of colorectal cancer increases gradually.Laparoscopic radical resection of colorectal cancer is an effective and commonly used treatment for colorectal cancer.Obesity has been confirmed to increase the risk of colorectal cancer,but the relationship between obesity and the prognosis of laparoscopic colorectal cancer patients remains controversial.And the indicators of obesity evaluation are different,but different methods have different accuracy,operability and cost.The purpose of this study was to investigate the effect of visceral fat area(VFA)on the prognosis of laparoscopic colorectal cancer.Methods:Using the electronic medical record management system of the Affiliated Hospital of Southwest Medical University for retrieval,the clinical data of 218 patients who underwent laparoscopic colorectal cancer radical operation in gastrointestinal surgery of the Affiliated Hospital of Southwest Medical University from March 2013 to June 2014 were analyzed retrospectively.Through the medical imaging system of the Affiliated Hospital of Southwest Medical University,CT scanning images of the navel(about L3-L5 level)of the patients were selected,and the threshold range of fat was set by the image processing software to mark the fat tissue as red,and VFA was selected and measured.According to the measured VFA value,it was divided into VFA-S group(VFA<100cm~2,n=106)and VFA-L group(VFA≥100cm~2,n=112).The basic clinical data of the two groups were compared.The measurement data were compared by t-test and the count data were compared byχ~2-test.Logistic regression was used to analyze the short-term prognosis.Kaplan Meier method was used to calculate the survival rate and draw the survival curve.Log rank method was used for the comparative analysis among groups.Cox proportional risk model was used to analyze the influencing factors of prognosis.Results:There was no significant difference between the two groups in clinical data such as sex,age,tumor location,tumor size,pathological type,differentiation degree,TNM stage,ASA grade,operation time,number of serious complications within 30 days,number of readmission patients within 30days,number of reoperation patients within 30 days,number of reoccurrence patients within 5 years and bleeding volume(P>0.05).However,the incidence of complications and minor complications in VFA-S group(13.2%,9.4%)were significantly lower than those in VFA-L group(27.7%,19.6%),and the difference was statistically significant(P<0.05).Logistic regression analysis showed that VFA was the risk factor of postoperative complications(OR=2.515,95%CI:1.251~5.055,P=0.010;OR=2.720,95%CI:1.283~5.768,P=0.009).The overall survival rate of patients in VFA-S group at 1 year,3 years,and 5 years(98.1%,87.7%,70.8%)was significantly greater than that of VFA-L group(93.8%,67.9%,58.0%),and the difference was statistically significant(P<0.05).The disease-free survival rate of patients in VFA-S group at 1 year,3 years,and 5 years(98.1%,84.0%,70.8%)was significantly greater than that of VFA-L group(92.0%,67.9%,58.0%),and the difference was statistically significant(P<0.05).Kaplan Meier curve showed that the overall and disease-free survival(58.91 months,57.82 months)in VFA-S group were significantly higher than that of VFA-L group(51.61 months,50.60 months),and the difference was statistically significant(P<0.05).Single factor Cox regression analysis of the overall and disease-free survival showed that they were related to ASA grade,differentiation degree,TNM stage and VFA,while multi factor Cox regression analysis showed that they were related to differentiation degree,TNM stage and VFA(P<0.05).Conclusion:VFA value has influence on short-term and long-term prognosis after laparoscopic colorectal cancer resection.VFA≥100cm~2 indicates that the patients are likely to have complications and poor prognosis.VFA is a simple and easily available index for obesity assessment,which can be used to predict the postoperative complications and prognosis of patients with laparoscopic colorectal cancer,and has a wide range of clinical value. |
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