The effects of sarcopenic obesity on immediate postoperative outcomes after pancreatoduodenectomy: a retrospective cohort study.

IF 1.2 4区医学 Q3 SURGERY

Annals of Surgical Treatment and Research Pub Date : 2024-10-01 Epub Date: 2024-09-30 DOI:10.4174/astr.2024.107.4.203

Jae Hwan Jeong, Ji Su Kim, Seung-Seob Kim, Seung Soo Hong, Ho Kyoung Hwang, Chang Moo Kang, Hyoung-Il Kim, Kyung Sik Kim, Sung Hyun Kim

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引用次数: 0

Abstract

Purpose: Several studies have evaluated the impact of sarcopenic obesity (SO) on postoperative complications, including postoperative pancreatic fistula (POPF), in patients undergoing pancreatoduodenectomy (PD). Previous studies have shown that SO increases POPF, but it remains unclear whether SO increases postoperative complications. In this study, we aimed to determine the relationship between SO and immediate postoperative complications.

Methods: From January 2005 to December 2019, the medical records of patients who underwent PD for periampullary cancer were retrospectively reviewed. Skeletal muscle index (SMI) and visceral fat area (VFA) were calculated from preoperative computed tomography images. Patients with high VFA were classified as obese, while those with low SMI were classified as sarcopenic. Patients were divided into 4 groups: normal group, sarcopenia only group, obesity only group, and SO group. Postoperative outcomes were compared between groups, and factors affecting postoperative complications were analyzed by multivariate analysis.

Results: Normal group (n = 176), sarcopenia only group (n = 130), obesity only group (n = 207), and SO group (n = 117) were analyzed retrospectively. SO group had significantly more frequent major complications compared to the normal group (P = 0.006), as well as a significantly more frequent clinically relevant POPF compared to the other groups (P = 0.002). In multivariate analysis, SO was an independent risk factor for major complications (P = 0.008) and clinically relevant POPF (P = 0.003).

Conclusion: SO is a factor associated with poor immediate postoperative outcomes after PD for periampullary cancer.

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肌肉松弛性肥胖对胰十二指肠切除术后即刻疗效的影响：一项回顾性队列研究。

目的：多项研究评估了肌肉松弛性肥胖（SO）对胰十二指肠切除术（PD）患者术后并发症（包括术后胰瘘（POPF））的影响。以往的研究表明，肥胖会增加胰瘘，但肥胖是否会增加术后并发症仍不清楚。在本研究中，我们旨在确定SO与术后即刻并发症之间的关系：方法：回顾性分析2005年1月至2019年12月期间接受胰周癌腹腔镜手术患者的病历。根据术前计算机断层扫描图像计算骨骼肌指数（SMI）和内脏脂肪面积（VFA）。VFA 高的患者被归类为肥胖，而 SMI 低的患者被归类为肌肉疏松。患者被分为 4 组：正常组、仅肌肉疏松组、仅肥胖组和 SO 组。比较各组的术后结果，并通过多变量分析对影响术后并发症的因素进行分析：结果：对正常组（176 人）、单纯肌少症组（130 人）、单纯肥胖症组（207 人）和 SO 组（117 人）进行了回顾性分析。与正常组相比，SO 组的主要并发症发生率明显更高（P = 0.006），与其他组相比，临床相关的 POPF 发生率也明显更高（P = 0.002）。在多变量分析中，SO 是主要并发症（P = 0.008）和临床相关 POPF（P = 0.003）的独立风险因素：结论：SO是导致胰周癌PD术后即刻预后不佳的相关因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Surgical Treatment and Research SURGERY-

CiteScore

2.30

自引率

7.10%

发文量

期刊介绍： Manuscripts to the Annals of Surgical Treatment and Research (Ann Surg Treat Res) should be written in English according to the instructions for authors. If the details are not described below, the style should follow the Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writing and Editing for Biomedical Publications available at International Committee of Medical Journal Editors (ICMJE) website (http://www.icmje.org).