腹腔脂肪面积与胃癌病人D2淋巴结清扫术后近期结果的关系

Relationship between intra-abdominal fat area and early outcomes after D2 lymphadenectomy in gastric cancer patients

目的:探讨腹腔脂肪面积(IFA)与胃癌病人D2淋巴结清扫术后近期结果的关系。方法:回顾性收集2010年5月至2011年9月在我院外科接受胃癌根治术的226例胃癌病人。术前通过多排螺旋CT(MDCT)扫描测量IFA。根据IFA中位数分为高IFA组(≥85 cm2)和低IFA组(<85 cm2)。记录病人术后胃周淋巴结剥出数及术后早期并发症,并行组间比较。结果:高IFA和低IFA组病人中位淋巴结检出数存在明显的统计学差异(P<0.001),但在手术时间和术中出血量方面无统计学差异。27例出现术后早期并发症,高IFA与低IFA组间并发症的发生率无统计学差异(P=0.091)。本研究无手术死亡病例。结论 :MDCT测量的IFA含量影响胃癌病人的术中淋巴结清扫数。

Objective To explore the relationship between the intra-abdominal fat area（IFA） and short-term outcomes after D2 lymphadenectomy in gastric cancer patients. Methods A total of 226 consecutive patients with gastric cancer who underwent radical resection from May 2010 to September 2011 were studied retrospetiviely. The patients were divieded into high IFA group （i〉85 cm2） and low IFA group （〈85 cm2） by the preoperative measurement of IFA with muhidetector computed tomography （MDCT） scan. The parameters including the numbers of lymph nodes retrieved and early postoperative complications were gotten and compared with between 2 groups. Results There was significant difference of the median values of the numbers of lymph nodes retrieved between high IFA group and low IFA group （P〈0.001）. However, no difference was present in both operative time and bleeding volume. Totally early postoperative complication occurred in 27 cases without difference between high IFA group and low IFA group （P=0.091）. There was no perioperative mortality in this study. Conclusions The IFA measured by MDCT is associated with the numbers of lymph nodes retrieved during the operations.