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Research ArticleClinical Studies

Relationship Between Fat Mass Indices and Postoperative Complications After Laparoscopic Gastrectomy in Patients With Gastric Cancer: A Propensity Score Matching Analysis

RYOTA MATSUI, NORIYUKI INAKI, TOSHIKATSU TSUJI and TETSU FUKUNAGA
Anticancer Research October 2022, 42 (10) 4841-4848; DOI: https://doi.org/10.21873/anticanres.15989
RYOTA MATSUI
1Department of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan;
2Department of Surgery, Juntendo University Urayasu Hospital, Urayasu, Japan;
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  • For correspondence: supreme0818@gmail.com
NORIYUKI INAKI
1Department of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan;
2Department of Surgery, Juntendo University Urayasu Hospital, Urayasu, Japan;
3Department of Gastrointestinal Surgery/Breast Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan;
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TOSHIKATSU TSUJI
1Department of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan;
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TETSU FUKUNAGA
2Department of Surgery, Juntendo University Urayasu Hospital, Urayasu, Japan;
4Department of Gastroenterology and Minimally Invasive Surgery, Juntendo University Hospital, Tokyo, Japan
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Abstract

Background/Aim: Visceral adipose tissue index (VAI) and visceral-to-subcutaneous adipose tissue area ratio (VSR) are indices related to visceral fat mass, and intramuscular adipose tissue content (IMAC) is an index related to intramuscular fat. We investigated the impact of fat mass-related indices on the incidence of postoperative complications. Patients and Methods: Patients who underwent radical laparoscopic gastrectomy for c-stage I primary gastric cancer between April 2014 and December 2020 were included. We investigated the relationship between both VAI, VSR, IMAC and postoperative complications. For each value, the median was used as a cut-off point, the patients were divided into high- and low-fat groups, and background adjustments using propensity score matching analysis were used to compare these two groups. Results: Of the 490 patients, 245 (50.0%) were in the high-VAI group, 243 (49.6%) in the high-VSR group, and 239 (48.8%) in the high-IMAC group. After matching, intra-abdominal abscess and pancreatic fistula were greater in the high-VAI group than those in the low-VAI group (p=0.081 and p=0.081, respectively), and were also significantly greater in the high-VSR group (p=0.012 and p=0.025, respectively). However, anastomotic leakage was greater in the high-IMAC group than in the low-IMAC group (p=0.050). Conclusion: VAI and VSR, which reflect visceral fat mass, were useful in predicting intra-abdominal infections, whereas IMAC, which reflects intramuscular fat, was useful in predicting anastomotic leakage. Preoperative prediction using a combination of these factors may aid clinical assessment of complication risk.

Key Words
  • Gastric cancer
  • intramuscular adipose tissue content
  • obesity
  • postoperative complication
  • visceral fat
  • Received July 12, 2022.
  • Revision received August 7, 2022.
  • Accepted August 8, 2022.
  • Copyright © 2022 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
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Anticancer Research: 42 (10)
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Vol. 42, Issue 10
October 2022
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Relationship Between Fat Mass Indices and Postoperative Complications After Laparoscopic Gastrectomy in Patients With Gastric Cancer: A Propensity Score Matching Analysis
RYOTA MATSUI, NORIYUKI INAKI, TOSHIKATSU TSUJI, TETSU FUKUNAGA
Anticancer Research Oct 2022, 42 (10) 4841-4848; DOI: 10.21873/anticanres.15989

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Relationship Between Fat Mass Indices and Postoperative Complications After Laparoscopic Gastrectomy in Patients With Gastric Cancer: A Propensity Score Matching Analysis
RYOTA MATSUI, NORIYUKI INAKI, TOSHIKATSU TSUJI, TETSU FUKUNAGA
Anticancer Research Oct 2022, 42 (10) 4841-4848; DOI: 10.21873/anticanres.15989
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Keywords

  • gastric cancer
  • intramuscular adipose tissue content
  • obesity
  • postoperative complication
  • visceral fat
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