腹腔内脂肪面积和体质量指数对腹腔镜结直肠癌根治术及术后短期结局的影响  

Impacts of intra-abdominal fat area and body mass index on laparoscopic surgery for colorectal cancer and short surgical outcomes

作　　者：吕文浩 王吉[1] 魏颖[1] 李卫东[1] LU Wen-hao;WANG Ji;WEI Ying;LI Wei-dong(Department of General Surgery,General Hospital,Tianjin Medical University,Tianjin 300070,China)

机构地区：[1]天津医科大学总医院普通外科,天津300070

出　　处：《天津医科大学学报》2018年第5期420-424,共5页Journal of Tianjin Medical University

摘　　要：目的:探讨腹腔内脂肪面积(IFA)及体质量指数(BMI)对结直肠癌病人腹腔镜结直肠癌根治术及术后短期结局的影响。方法:回顾性收集2015年5月-2017年1月我院普通外科收治的74例腹腔镜结直肠癌根治术的患者。术前计算患者BMI,并通过多层螺旋CT(MSCT)扫描测量IFA。根据BMI中国标准分为超重组(BMI>24 kg/m^2),非超重组(BMI≤23.9 kg/m^2)。以IFA≥100cm^2为区分标准,将病人分为高脂肪量组(H-IFA,IFA≥100 cm^2)和低脂肪量组(L-IFA,IFA<100 cm^2)。比较各组患者之间术后肠周淋巴结清扫数、术中出血量、手术时间、术后住院天数及短期术后并发症等临床参数。结果:H-IFA组的淋巴结检出数(13.83±4.96)枚低于L-IFA组的淋巴结检出数(18.81±5.67)枚,H-IFA组的术中出血量(154.39±157.97)mL高于L-IFA组的术中出血量(80.30±68.12)mL,H-IFA组的患者年龄(68.27±8.34)岁高于L-IFA组的患者年龄(62.6±10.84岁),上述差异具有统计学意义(P<0.05)。超重组和非超重组于患者年龄、淋巴结检出数、术中出血量之间、手术时间无显著性差异(P>0.05)。14例患者出现术后早期并发症,H-IFA与L-IFA组间及肥胖及非肥胖组间并发症的发生率无显著性差异(P>0.05)。H-IFA与L-IFA中不同BMI与年龄、性别、手术之间及并发症之间的差异无统计学意义,高IFA且超重的患者住院时间(18.15±9.36)d,要长于非超重患者的住院时间(13.21±2.86)d,(P<0.05)。结论:MSCT测量的IFA较BMI可更精确地评估腹腔镜结直肠癌根治术的手术难易程度。Objective： To explore the effect of intra-abdominal fat area and body mass index on early surgical outcomes for patients who underwent laparoscopic resection of colorectal cancer. Methods： Retrospectively we collected data of 74 patients with colorectal cancer who underwent laparoscopic resection of colorectal cancer from May 2015 to January 2017 in general surgery department of our hospital. According to intra-abdominal fat area （IFA） gained from MSCT, they were assigned into two groups： low intra-abdominal fat area group （L-IFA） and high- intra-abdominal fat area group （H-IFA）. According to body mass index, they were separated into two groups： overweight group and non-overweight group. Parameters such as intraoperative blood loss, time of operation, postoperative hospital stay, the numbers of lymph nodes retrieved and surgical and nonsurgical complications were recorded and compared among groups. Results： According to IFA, the mean values of the numbers of lymph nodes retrieved in H-IFA group（13.83±4.96） was lower than that in L-IFA group （18.81±5.67）, intraoperative blood loss in H-IFA group [（154.39±157.97）mL]was higher than that in L-IFA group[（80.30±68.12）mL]，the ages of patients in H-IFA group（68.27±8.34） was higher than those in L-IFA group （62.6±10.84）， and those differences were significant between the two groups（P＜0.05）. According to BMI, the mean values of the numbers of lymph nodes retrieved, intraoperative blood loss, ages of patients were not significantly different among three groups（P＞0.05）. No significant differences were found with regard to the early surgical complications in IFA groups and BMI groups. Combined with over-weight patients, patients with H-IFA have significantly longer hospital-stay[（18.15±9.36）d] than the rest [（13.21±2.86）d] （P＜0.05）.Conclusion： Intra-abdominal fat area measured by MS CT can better indicate the difficulty of laparoscopic resection of colorectal cancer than BMI.

关 键 词：结直肠癌 腹腔镜 腹腔内脏脂肪面积 体质量指数 

分 类 号：R735.37[医药卫生—肿瘤]