Computed Tomography-based Assessment of Visceral Fat for Predicting Intra-abdominal Infectious Complications After
Itaru Hashimoto1, Yukio Maezawa2, Ayako Tamagawa2
1Department of Surgery, Yokohama City University, Yokohama, Japan hashimoto.ita.ic@yokohama-cu.ac.jp.
Background/Aim:
Obesity is associated with an increased risk of postoperative complications after gastrectomy, potentially due to increased visceral fat and greater technical difficulty during surgery. The body mass index (BMI) is commonly used to assess obesity. However, it does not adequately reflect fat distribution. This study evaluated the association between the visceral fat area (VFA) measured on preoperative computed tomography (CT) and intra-abdominal infectious complications (IAIC) after gastrectomy for gastric cancer (GC).
Patients And Methods:
A total of 183 patients who underwent gastrectomy for GC between 2015 and 2019 were analyzed retrospectively. IAIC was defined as anastomotic leakage, pancreatic fistula, or an intra-abdominal abscess of Clavien-Dindo grade II or higher. VFA was quantified at the level of the third lumbar vertebra (L3) using preoperative CT images. Associations between clinicopathological factors and IAIC were examined using a multivariate logistic regression analysis. A receiver operating characteristic (ROC) curve analysis was performed to compare the predictive performance of VFA and BMI.
Results:
A high VFA was an independent risk factor for IAIC (odds ratio 3.99, 95% confidence interval=1.57-10.10, p=0.004). VFA demonstrated a greater predictive ability for IAIC than BMI in the ROC analysis (area under the curve: 0.623 vs. 0.509, p=0.002).
Conclusion:
The preoperative VFA may be a useful indicator of IAIC after gastrectomy for GC.
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