Prediction of the Risk of Laparoscopy-Assisted Gastrectomy by Comparing Visceral Fat Area and Body Mass Index

Abstract

Propose The purpose of this study was to compare the accuracy of visceral fat area (VFA) and body mass index (BMI) in predicting the risk of laparoscopic-assisted gastrectomy. Methods Clinicopathological and imaging data of 133 patients who underwent laparoscopy-assisted gastrectomy were recorded, including 17 cases of conversion to open surgery. The remaining 116 patients were retrospectively analyzed after we excluded 17 patients who had been transferred to laparotomy. The patients were divided into two groups according to BMI (≤25 kg/m2: BMI-L group; >25 kg/m2: BMI-H group) and VFA (≤100 cm2: VFA-L group; >100 cm2: VFA-H group). Clinical outcomes were compared between the BMI and VFA subgroups. Results There were no differences in intraoperative blood loss and the number of harvested lymph nodes between low and high patients defined by BMI and VFA (p > 0.050). However, in the comparison of patients who underwent laparoscopic resection only, it was found that the operation time and intraoperative blood loss of the VFA-H group were more than those of the VFA-L group (p < 0.050). Compared to the VFA-L group, the VFA-H group had later first exhaust time (p = 0.018), more complications (p < 0.001), and longer hospital stays (p = 0.049). However, no similar conclusion was obtained in the BMI group (p > 0.050). Conclusion This study demonstrates that VFA better evaluates the difficulty of laparoscopy-assisted gastrectomy and the risk of postoperative complications than BMI.

Low psoas muscle index is a poor prognostic factor for lower gastrointestinal perforation: a single-center retrospective cohort study

“…PMI is a simple but reliable method of prognostic evaluation similar to SOFA. Body composition has recently been reported as a risk factor or prognostic factor for postoperative complications [3,5,24,25]. In particular, skeletal muscle mass is considered important [26][27][28].…”

Diffuse Reduction of Spleen Density Is an Independent Predictor of Post-Operative Outcomes After Curative Gastrectomy in Gastric Cancer: A Multi-Center Study

“…Does obesity affect the prognosis of cancer patients? Visceral fat area, as an evaluation index of obesity, can evaluate operative difficulties and is reportedly associated with post-operative complications (29,30). However, BMI has little to do with long-term prognosis in the present study (P > 0.05).…”

<p>Value of Visceral Fat Area in the Preoperative Discrimination of Peritoneal Metastasis from Gastric Cancer in Patients with Different Body Mass Index: A Prospective Study</p>

“…Recently, increasing attention has been paid to VFA and BMI as obesity indexes. Previous studies found VFA to be superior to BMI in accurately and effectively predicting the effect of obesity on adverse postoperative outcomes [22][23][24] after radical colectomy as well as radical gastrectomy. However, all the studies focused on the comparison of two indications and whether VFA is a better parameter than BMI remains controversial.…”