腹部体型参数对腹腔镜远端胃癌D2根治术围术期并发症及术后恢复的影响

Influenceofabdominal body shape parameters onperioperative complications and postoperative recovery in patients with laparoscopy-assisteddistal D2 resectionfor gastric cancer

目的探讨腹部体型参数对腹腔镜辅助远端胃癌D2根治术(LADG)病人围术期并发症及术后恢复的影响。方法LADG治疗的病人168例,术前4天计算体重指数(BMI)、腰臀比(WHR)。采用全腹部CT测定腹部体型参数[脐周腹壁脂肪厚度平均值(NMT)和腹部内脏脂肪厚度(VFT)]。统计术中及术后康复指标、并发症发生情况。结果168例病人中,发生围手术期并发症32例,并发症发生率19.05%。Pearson相关性分析显示,NMT与术后肛门排气时间、进食时间及住院时间呈显著正相关(P<0.05),VFT与淋巴结清扫数呈负相关(P<0.05),与手术时间呈显著正相关(P<0.05)。多因素Logistic回归分析显示,术前合并症是影响围手术期并发症的独立危险因素(P<0.05)。结论腹部体型参数对LADG病人术中情况及术后康复具有一定影响,但对围手术期并发症发生的影响不明显。

Objective To investigate the influenceof abdominal body shape parameters on perioperative complications and postoperative recovery in patients with laparoscopy-assisted distal D2 resection for gastric cancer(LADG).Methods 168 gastric cancer patients who underwent LADG were enrolled.The body mass index(BMI)and waist-to-hip ratio(WHR)were measured 4days before surgery,the abdominal body parameters[average umbilical abdominal wall thickness(NMT)and abdominal visceral fat thickness(VFT)]was measured by CT.The intraoperative and postoperative rehabilitation indicators and complications were counted.Results Of the 168 patients,32 cases had perioperative complications,the complication rate was 19.05%.The Pearson correlation analysis showed that NMT was significantly positively correlated with postoperative anal exhaust time,eating time and hospital stay(P<0.05),VFT was negatively correlated with lymph node dissection(P<0.05),and VFT was positively correlated with operation time(P<0.05).Multivariate logistic regression analysis showed that preoperative complications were independent risk factors for perioperative complications(P<0.05).Conclusion Abdominal body parameters have certain influence on the intraoperative and postoperative rehabilitation condition of LADG patients,but the effect on perioperative complications is not obvious.