Effect of individual fat areas on early surgical outcomes after open gastrectomy for gastric cancer.
BACKGROUND
Obesity is generally considered a risk factor for postoperative morbidity following open gastrectomy. Body mass index (BMI) is widely accepted as an indicator of obesity, but does not necessarily reflect the distribution of fat. It is unclear how different types of fat may affect the operative procedure and outcome.


METHODS
The relationship between fat area (total, visceral and subcutaneous fat, and BMI) and early surgical outcomes (bleeding, operating time, morbidity, hospital death and hospital stay) was investigated in 135 patients who had a curative gastrectomy at the Cancer Institute Hospital, Tokyo, in 2006.


RESULTS
Postoperative intra-abdominal infection, which occurred in 13 patients (9.6 per cent), correlated strongly with visceral (P = 0.023) and total (P = 0.037) fat area. Visceral fat area also correlated with hospital death (P = 0.041) and a longer hospital stay (P = 0.001). Subcutaneous fat area and BMI did not correlate with these early surgical outcomes.


CONCLUSIONS
Patients with a high visceral fat area are more likely to develop an intra-abdominal infection after gastrectomy. Assessment of fat area, in particular visceral fat area, should alert surgeons to increased postoperative risks.
Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
M
M
Tokunaga
N
N
Hiki
T
T
Fukunaga
T
T
Ogura
S
S
Miyata
T
T
Yamaguchi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D005743:Gastrectomy; D006801:Humans; D050152:Intra-Abdominal Fat / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000473:pathology; D011183:Postoperative Complications / Q000209:etiology*; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome