ABSTRACT
Objective:To explore the effect of excessive visceral fat area (VFA) on the intraoperative risk and postoperative outcome of laparoscopic-assisted distal gastric cancer surgery (LADG).Methods:A retrospective selection of 82 patients who underwent LADG at the Department of General Surgery, Beijing Friendship Hospital, Capital Medical University from June 2017 to March 2018 was selected. The patients were divided into two groups according to the VFA value calculated by preoperative CT: high VFA group ( n=31) and the low VFA group ( n=51). Patients in the high-VFA group had VFA≥100 cm 2, and those in the low-VFA group had VFA<100 cm 2. The differences in operation time, blood loss, number of lymph node dissections, and postoperative complications (including intestinal obstruction, anastomotic fistula, pancreatic fistula, and abdominal infection) were statistically compared between the two groups. Measurement data were expressed as mean±standard deviation ( Mean± SD), comparison between groups was by t-test; comparison of count data between groups was by Chi-square test. The factors related to pancreatic fistula were tested by one-way variance test, and the factors with differences were entered into the multivariate Logistic regression analysis as independent variables. Results:In terms of surgical bleeding ( P=0.061), lymph node dissection ( P=0.089), postoperative anastomotic leakage ( P=0.210), intestinal obstruction ( P=0.275) and abdominal infection ( P=0.130), the comparison between the two groups showed no significant statistical difference ( P>0.05), but compared with the low VFA group, the operation time of the high VFA group was prolonged [(258±91)min vs (230±82)min, P=0.018], and the onset of pancreatic fistula rate was significantly higher (11/31 vs 3/51, P=0.001), and there was statistical significance between the two groups ( P<0.05). The results of univariate analysis showed that gender and VFA were risk factors for pancreatic fistula; the results of multivariate analysis showed that VFA was a predictor of pancreatic fistula. Conclusion:Excessive VFA prolongs LADG operation time and is more valuable in predicting the occurrence of postoperative pancreatic fistula.