Clinical value of preoperative computed tomography analysis of body composition after radical gastrectomy
Objective To assess the relationship between body composition alteration and complications after radical gastrectomy through analyzing morphometric parameters from preoperative computed tomography(CT)images.Methods The relevant clinical data were retrospectively reviewed for 118 patients undergoing radical gastrectomy from January 2020 to January 2023.Baseline profiles,body composition parameters,surgical findings and postoperative morbidities were recorded.Logistic regression analysis was performed for examining the factors associated with occurrence of postoperative complications.Results There were 76 males and 42 females with an average age of 66.5 year.Visceral obesity,sarcopenia and myosteatosis occurred in 30.5%(36/118),35.6%(42/118)and 39.8%(47/118).There were total gastrectomy(n=29)and subtotal gastrectomy(n=89).Incidence of delayed gastric emptying,wound infection,pulmonary disease,surgical site infection,anastomotic leakage and postoperative hemorrhage were 13.6%(16/118),11.0%(13/118),10.2%(12/118),9.3%(11/118),6.8%(8/118)and 3.4%(4/118)respectively.Complications above Clavien-Dindo Ⅲ accounted for 7.6%(9/118).Visceral obesity was correlated closely with prolonged operative duration and greater intraoperative hemorrhage.Individuals with sarcopenia were more prone to anastomotic leakage and abdominal infection.In patients of myosteatosis,the incidence of postoperative gastric emptying disorders and pulmonary complications(as well as overall complications)was higher in those without myosteatosis.Multivariate logistic regression analysis indicated that myosteatosis was independent risk factor for postoperative complications after radical gastrectomy[OR=4.256,95%CI(1.192,9.475),P= 0.001].Conclusion Preoperative CT images may accurately reflect the body composition of patients for further evaluations of nutrition status.And occurrence of complications are correlated closely with the alteration of body composition after radical gastrectomy.
万方数据
维普
