The Study Of Abdominal Visceral Fat Area In Patients With Rectal Cancer

Objective:To study the differences in postoperative related indicators,recent complications,and long-term survival of patients undergoing rectal cancer surgery about various VFA subgroups.Methods:The clinical data of 161 patients with rectal cancer treated by surgery in Shaanxi Provincial People’s Hospital from June 2016 to July 2019 were retrospectively analysis.Compare with the differences between patients of genders in visceral fat area,patients were divided into high VFA,low VFA groups,high BMI and low BMI groups.Collect the informations about basic clinical data,surgery-related indicators,recent postoperative complications and postoperative symptomatic supportive treatment.Long-term follow-up of patients with rectal cancer are needed to study patient survival.IBM SPSS Statistics 23.0,Excel 2019 and Graph Pad Prism 9.3 were used to compare the analysis of patients with different VFA and BMI.Enumeration data were counted by the number of cases or percentage,and the comparison between groups was performed byχ~2test.The measurement data were tested for normal distribution and conformed to normal distribution using mean±standard deviation and t-test between groups.Survival analysis was performed using the Kaplan-Meier method for statistical analysis and the Log-rank test;P<0.05 indicates a statistically significant difference.Results:Compared with the patients in the low VFA group,there are more in the high VFA group had diabetes mellitus;more patients in the high BMI group had combined hypertension compared with those in the low BMI group;both differences were statistically significant(P<0.05).There was no statistically significant difference in clinicopathological findings between patients in the high VFA group compared with those in the low VFA group(P>0.05).Compared with patients in the low VFA group,patients in the high VFA group had longer operative time,increased intraoperative bleeding,decreased number of intraoperative lymph node dissection,and significantly increased postoperative fasting time,postoperative venting time,gastric tube retention time,and postoperative hospital stay,and the differences were statistically significant(P<0.05).In contrast,patients in the high BMI group had significantly longer operative time and longer gastric tube retention time compared with those in the low BMI group(P<0.05).Patients in the high VFA group had a higher incidence of postoperative complications in patients(27.5%)compared with patients in the low VFA group(14.5%),and patients in the high VFA group had a higher incidence of incisional complications(18.8%)compared with patients in the low VFA group(6.2%),and the difference was statistically significant(P<0.05),while the difference in postoperative anastomotic complications and pulmonary-related complications were not statistically significant(P>0.05).In contrast,the incision-related postoperative complication rate was higher in patients in the high BMI group(19.0%)than in patients in the low BMI group(8.2%),and the difference was statistically significant(P<0.05).Univariate and multifactorial analyses of the occurrence of postoperative complications identified intraoperative bleeding≥300 ml and vascular cancer embolism as independent risk factors for the occurrence of postoperative complications in patients with rectal cancer.In the long-term follow-up study of patients,it was found that the overall postoperative survival time of patients in the high VFA group was(36.3±12.9)months vs.the mean postoperative survival time of patients in the low VFA group was(41.5±11.4)months,and the disease-free survival time of patients in the high VFA group was(33.7±15.1)months vs.the disease-free survival time of patients in the low VFA group was(38.7±14.8)months,and the difference between the two was The difference was statistically significant(P<0.05).The overall postoperative survival time in the high BMI group was(37.0±12.1)months vs(40.2±12.5)months in the low BMI group,and the disease-free survival time in the high BMI group was(33.3±15.3)months vs(38.1±14.8)months in the low BMI group,but the differences were not statistically significant(P>0.05).Conclusion:1.A larger abdominal visceral fat area affects the operative time,intraoperative blood volume,and the number of intraoperative lymph node dissection in patients with rectal cancer,as well as affects the recovery of gastrointestinal function and prolongs postoperative hospitalization;it affects the occurrence of postoperative complications in perioperative patients.2.Overall survival time and disease-free survival time after surgery were significantly shorter in patients with rectal cancer with large abdominal visceral fat area than in patients with small abdominal visceral fat area.3.Abdominal visceral fat area can be used as a body mass index(BMI)to assist in the assessment of postoperative recovery of abdominally obese rectal cancer patients.