Trunk fat volume can be a predictor of postoperative complications after gastrectomy: a retrospective cohort study

Abstract

Background Obesity can affect postoperative outcomes of gastrectomy. Visceral fat area is superior to body mass index in predicting postoperative complications. However, visceral fat area measurement is time-consuming and is not optimum for clinical use. Meanwhile, trunk fat volume (TFV) can be easily measured via bioelectrical impedance analysis. Hence, the current study aimed to determine the ability of TFV to predict the occurrence of complications after gastrectomy. Methods We retrospectively reviewed patients who underwent curative gastrectomy for gastric cancer between November 2016 and November 2019. The trunk fat volume-to-the ideal amount (%TFV) ratio was obtained using InBody 770 before surgery. The patients were classified into the obese and nonobese groups according to %TFV (TFV-H group, ≥ 150%; TFV-L group, < 150%) and body mass index (BMI-H group, ≥ 25 kg/m2; BMI-L group, < 25 kg/m2). We compared the short-term postoperative outcomes (e.g., operative time, blood loss volume, number of resected lymph nodes, and duration of hospital stay) between the obese and nonobese patients. Risk factors for complications were assessed using logistic regression analysis. Results In total, 232 patients were included in this study. The TFV-H and BMI-H groups had a significantly longer operative time than the TFV-L (p = 0.022) and BMI-L groups (p = 0.006). Moreover, the TFV-H group had a significantly higher complication rate (p = 0.004) and a lower number of resected lymph nodes (p < 0.001) than the TFV-L group. In the univariate analysis, %TFV ≥ 150, total or proximal gastrectomy, and open gastrectomy were found to be potentially associated with higher complication rates (p < 0.1 for all). Moreover, the multivariate analysis revealed that %TFV ≥ 150 (OR: 2.73; 95% CI: 1.37–5.46; p = 0.005) and total or proximal gastrectomy (OR: 3.57; 95% CI: 1.79–7.12; p < 0.001) were independently correlated with postoperative morbidity. Conclusions %TFV independently affected postoperative complications. Hence, it may be a useful parameter for the evaluation of obesity and a predictor of complications after gastrectomy.

Body composition index obtained by using a bioelectrical impedance analysis device can be a predictor of prolonged operative time in patients undergoing minimally invasive colorectal surgery

“…However, there have been no studies on other indicators of short-term outcomes and operative time using the BIA device, except for skeletal muscle mass, in patients who had undergone colorectal surgery. Shiomi et al [ 39 ] reported that trunk fat volume measured by using a BIA device can be a useful parameter for the evaluation of obesity and a predictor of complications after gastrectomy.…”

Effect of body fat mass loss on prognosis of radical resection for pancreatic ductal adenocarcinoma based on bioelectrical impedance analysis

“…BIA is widely used as it is a simple and non-invasive method that provides accurate results [19,20]. Several reports have evaluated postoperative changes in body composition using BIA and analyzed the risk factors for postoperative complications in patients with gastric cancer [21][22][23]. Moreover, in patients with colorectal cancer, a preoperative low SMI based on the BIA method was considered a risk factor for postoperative ileus [24], and preoperative visceral fat area measured by BIA was an independent prognostic factor for disease-free survival [25].…”

Evaluation of Morphometric Measurements on Preoperative CT Angiograms to Determine Risk of Abdominal Donor Site Complications—A Retrospective Review of 174 Patients

“…14–16 Regarding direct surgical factors, previous literature has demonstrated increased visceral fat volume associated with predisposition to multiple cancers, prolonged hospital stay, and increased risk of hospital mortality. 17–19 The mechanism by which increasing visceral fat results in an increased risk for infection, seroma, and epidermolysis is unclear but may be secondary to compromised vascular endothelial function and angiogenesis. 20…”

“…[14][15][16] Regarding direct surgical factors, previous literature has demonstrated increased visceral fat volume associated with predisposition to multiple cancers, prolonged hospital stay, and increased risk of hospital mortality. [17][18][19] The mechanism by which increasing visceral fat results in an increased risk for infection, seroma, and epidermolysis is unclear but may be secondary to compromised vascular endothelial function and angiogenesis. 20 Prior studies evaluating the impact of preoperative CTA abdominal visceral adipose distribution on donor site complications in patients undergoing abdominally based autologous reconstruction have demonstrated inconsistent findings.…”