内脏脂肪面积作为胃癌患者术后并发症预测指标有效性的Meta分析

Effectiveness of visceral fat area as a predictor of postoperative complications in patients with gastric cancer:A Meta-analysis

目的通过对不同内脏脂肪面积的胃癌患者术后并发症发生情况进行Meta分析,评价内脏脂肪面积作为预测并发症发生风险指标的有效性。方法在Pubmed、Cochrane library、Embase、中国知网、万方数据库,检索自2000年1月~2023年1月发表的对比不同内脏脂肪面积的胃癌患者围术期相关指标的研究,纳入文献后进行质量评价,提取文献基本信息和数据,Meta分析应用Revman 5.4软件进行。结果共纳入12篇文献2956例患者,其中高内脏脂肪面积组1214例,低内脏脂肪面积组1742例。与低内脏脂肪面积组患者比较,高内脏脂肪面积组患者术后胰瘘、吻合口瘘、切口感染、腹腔感染发生率较高,手术时间更长,术后住院时间更长,术中失血量更多。而两组患者在术后呼吸道感染、肠梗阻发生率以及淋巴结清扫的数目上,差异无统计学意义。结论高内脏脂肪面积增加了胃癌患者术后发生胰瘘、吻合口瘘等并发症的风险,延长了手术时间与住院时间。因此,有必要对胃癌患者进行术前风险评估,并采取适当的干预措施,以期降低术后并发症的发生率,减轻病人痛苦和经济负担。

Objective To evaluate the effectiveness of visceral fat area as an indicator for predicting the risk of complications in gastric cancer patients with different visceral fat areas by Meta-analysis.Methods In PubMed,Cochrane library,Embase,CNKI and Wanfang Data,the studies from January 2000 to January 2023 were retrieved on the comparison of perioperative indicators of gastric cancer patients with different visceral fat areas.After screening the qualified literatures,the quality assessment was performed,and the relevant information and data of the literatures were extracted.The Revman 5.4 software was used for Meta-analysis.Results A total of 12 literatures involving 2956 patients were enrolled,including 1214 patients in the high visceral fat area group and 1742 patients in the low visceral fat area group.Patients in the high visceral fat area group had higher incidence of postoperative pancreatic fistula,anastomotic fistula,incision infection and ab-dominal infection,longer operation time,longer postoperative hospital stay and more intraoperative blood loss than those in the low visceral fat area group.There was no significant difference in the incidence of postopera-tive respiratory infection,intestinal obstruction or the number of lymph node dissection between the two groups.Conclusions High visceral fat area increases the risk of postoperative complications such as pancreatic fistula and anastomotic leakage in patients with gastric cancer,and prolongs the operation time and hospital stay.Therefore,it is necessary to assess the risk of gastric cancer patients before operation and take appropriate intervention measures to reduce the probability of postoperative complications and reduce the pain and economic burden of them.