中国普通外科杂志2024，Vol.33Issue(7)：1142-1152,11.DOI:10.7659/j.issn.1005-6947.2024.07.013
内脏脂肪面积对胃癌根治术疗效、术后并发症及患者预后影响的Meta分析
Meta-analysis of the impact of visceral fat area on the efficacy,postoperative complications,and patients'prognosis of radical gastrectomy
摘要
Abstract
Background and Aims:Visceral obesity is not only a risk factor for various cancers but also closely related to surgical outcomes and the occurrence of postoperative complications.Although there are numerous studies on the impact of visceral fat area(VFA)on the efficacy and postoperative complications of radical gastrectomy as well as postoperative survival of patients,there is still a lack of comparative analysis with large sample sizes.Therefore,this study was performed to explore the relationship between VFA defined by CT at the third lumbar vertebra level(L3-CT)and the efficacy,postoperative complications,and prognosis of radical gastrectomy through a Meta-analysis. Methods:A comprehensive search was conducted across multiple domestic and international databases to collect clinical studies comparing the postoperative outcomes of gastric cancer patients with different VFAs(all calculated by L3-CT).The search period was from the inception of the database to July 2023.After literature screening according to inclusion and exclusion criteria,data extraction,Meta-analysis was performed using RevMan 5.3 software. Results:A total of 9 studies meeting the criteria were included,with 6 retrospective cohort studies and 3 prospective studies,comprising a total sample size of 4 521 cases.The NOS scores of the included studies ranged from 7 to 9.Meta-analysis results showed that the high VFA group had longer operative time(MD=19.59,95％CI=0.93-38.25,P=0.04),greater blood loss(MD=60.79,95％CI=10.20-1 11.38,P=0.02),and fewer lymph nodes dissected(MD=-4.85,95％CI=-6.11-3.60,P＜0.000 01).The high VFA group also had prolonged postoperative hospital stay(MD=1.75,95％CI=0.99-2.51,P＜0.000 01).VFA was associated with the overall incidence of complications(OR=1.57,95％CI=1.32-1.87,P＜0.000 01),with the high VFA group more likely to develop pancreatic fistula(OR=2.58,95％CI=1.41-4.69,P=0.002)and anastomotic leakage(OR=1.77,95％CI=1.12-2.79,P=0.01).There was no statistically significant difference in the 5-year survival rate between the different VFA groups(OR=1.17,95％CI=0.92-1.49,P=0.21). Conclusions:High VFA prolongs operative time,with increased intraoperative blood loss,reduced the number of lymph nodes dissected,and makes patients more prone to pancreatic fistula and anastomotic leakage.Due to the limitations in the number and quality of studies,these conclusions require further validation through higher quality studies.关键词
胃肿瘤/内脏脂肪/预后/Meta分析Key words
Stomach Neoplasms/Visceral Fat/Prognosis/Meta-Analysis分类
医药卫生引用本文复制引用
马于祺,马云涛,毕心然,张文涛,龚世怡,万浩浩,马亮,范万琦,邓渊,狐鸣..内脏脂肪面积对胃癌根治术疗效、术后并发症及患者预后影响的Meta分析[J].中国普通外科杂志,2024,33(7):1142-1152,11.基金项目
国家卫健委胃肠肿瘤诊治重点实验室基金资助项目(NLDTG2022009) （NLDTG2022009）
甘肃省自然科学基金资助项目(22JR7RA649 （）
2020-ZD-29). （）
