Abstract
Background
Obesity may impact surgical outcomes of gastrectomy. Whether visceral fat area (VFA) is a better obesity parameter than body mass index (BMI) is still controversial. The aim of this study is to compare the accuracy and effectiveness of VFA and BMI in predicting the short-term surgical outcomes of gastrectomy.
Methods
Patients who were diagnosed with gastric cancer were measured for BMI and VFA preoperatively and then divided into a VFA-H (VFA-high) group and VFA-L (VFA-low) group, at the cutoff point of 100 cm2, and a BMI-H (BMI-high) group and BMI-L (BMI-low) group, at the cutoff point of 25 kg/m2. The short-term surgical outcomes were compared between the different groups.
Results
In total, 276 patients were enrolled in this study; 55 (19.9%) patients were classified into the BMI-H group, and 122 (44.2%) patients were classified into the VFA-H group. There was a significant correlation between BMI and VFA (r = 0.652, p < 0.001). Compared with the VFA-L group, the VFA-H group had a higher incidence of postoperative complications (31.1% vs. 13.0%; p < 0.001), longer operation duration (270.0 (235.0–305.0) vs. 255.0 (223.8–295.0), p = 0.046), and more blood loss (100.0 (100.0–150.0) vs. 80.0 (80.0–100.0), p < 0.001), while the BMI-H group had more blood loss than the BMI-L group (100.0 (100.0–120.0) vs. 100.0(80.0–100.0), p = 0.006). Logistic regression showed that VFA was an independent risk factor for postoperative complications (odds ratio 2.813, 95% CI 1.523–5.194; p = 0.001).
Conclusion
For gastric cancer patients, VFA is superior to BMI in accurately and effectively illuminating the impact of obesity on short-term surgical outcomes.
Trial Registration
Clinicaltrials.gov: NCT02800005.
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Acknowledgments
The authors thank the valuable work of the Volunteer Team of Gastric Cancer Surgery (VOLTGA) West China Hospital, Sichuan University, China, for the establishment and updating of the gastric cancer database.
Funding
This study is supported by grants of National Natural Science Foundation of China, No.81301866; Sichuan Province Youth Science Technology Innovative Research Team, No.2015TD0009; 1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University (ZY2017304); Fund for Fostering Academic and Technical Leaders of Sichuan Province, No. [2017]919; and Foundation of Science & Technology Department of Sichuan Province (No. 2018SZ0147).
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Yang, Sj., Li, Hr., Zhang, Wh. et al. Visceral Fat Area (VFA) Superior to BMI for Predicting Postoperative Complications After Radical Gastrectomy: a Prospective Cohort Study. J Gastrointest Surg 24, 1298–1306 (2020). https://doi.org/10.1007/s11605-019-04259-0
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DOI: https://doi.org/10.1007/s11605-019-04259-0