Artificial Intelligence-Derived Intramuscular Adipose Tissue Assessment Predicts Perineal Wound Complications Following Abdominoperineal Resection.

IF 2.5 3区医学 Q2 SURGERY

World Journal of Surgery Pub Date : 2025-09-15 DOI:10.1002/wjs.70095

Alex Besson, Ke Cao, Rory Kokelaar, Emina Hajdarevic, Lara Wirth, Josephine Yeung, Justin M Yeung

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引用次数: 0

Abstract

Background: Perineal wound complications following abdominoperineal resection (APR) significantly impacts patient morbidity. Despite various closure techniques, no method has proven superior. Body composition is a key factor influencing postoperative outcomes. AI-assisted CT scan analysis is an accurate and efficient approach to assessing body composition. This study aimed to evaluate whether body composition characteristics can predict perineal wound complications following APR.

Methods: A retrospective cohort study of APR patients from 2012 to 2024 was conducted, comparing primary closure and inferior gluteal artery myocutaneous (IGAM) flap closure outcomes. Preoperative CT scans were analyzed using a validated AI model to measure lumbosacral skeletal muscle (SM), intramuscular adipose tissue (IMAT), visceral adipose tissue, and subcutaneous adipose tissue.

Results: Greater IMAT volume correlated with increased wound dehiscence in males undergoing IGAM closure (40% vs. 4.8% and p = 0.027). Lower SM-to-IMAT volume ratio was associated with higher wound infection rates (60% vs. 19% and p = 0.04). Closure technique did not significantly impact wound infection or dehiscence rates.

Conclusion: This study is the first to use AI derived 3D body composition analysis to assess perineal wound complications after APR. IMAT volume significantly influences wound healing in male patients having IGAM reconstruction.

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人工智能衍生的肌内脂肪组织评估预测腹会阴切除术后会阴伤口并发症。

背景：腹会阴切除术（APR）后会阴伤口并发症显著影响患者的发病率。尽管有各种各样的封闭技术，但没有一种方法被证明是更好的。体成分是影响术后预后的关键因素。人工智能辅助CT扫描分析是一种准确有效的评估身体成分的方法。方法：对2012 - 2024年APR患者进行回顾性队列研究，比较初次闭合与臀下动脉肌皮瓣（IGAM）闭合效果。术前CT扫描使用经过验证的AI模型进行分析，测量腰骶骨骼肌（SM）、肌内脂肪组织（IMAT）、内脏脂肪组织和皮下脂肪组织。结果：在IGAM闭合的男性患者中，较大的IMAT体积与伤口裂开增加相关（40%比4.8%,p = 0.027）。较低的sm - imat体积比与较高的伤口感染率相关（60%比19%，p = 0.04）。缝合技术对伤口感染和裂开率无显著影响。结论：本研究首次使用人工智能衍生的三维体成分分析来评估apr术后会阴创面并发症。IMAT体积对男性IGAM重建患者创面愈合有显著影响。

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

World Journal of Surgery 医学-外科

CiteScore

5.10

自引率

3.80%

发文量

460

审稿时长

3 months

期刊介绍： World Journal of Surgery is the official publication of the International Society of Surgery/Societe Internationale de Chirurgie (iss-sic.com). Under the editorship of Dr. Julie Ann Sosa, World Journal of Surgery provides an in-depth, international forum for the most authoritative information on major clinical problems in the fields of clinical and experimental surgery, surgical education, and socioeconomic aspects of surgical care. Contributions are reviewed and selected by a group of distinguished surgeons from across the world who make up the Editorial Board.