scholarly journals The Incidence of Postoperative Complications after Gastrectomy Increases in Proportion to the Amount of Preoperative Visceral Fat

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Kazuyuki Okada ◽  
Tatsuto Nishigori ◽  
Kazutaka Obama ◽  
Shigeru Tsunoda ◽  
Koya Hida ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Postoperative Complications ◽  
Visceral Fat ◽  
Visceral Obesity ◽  
Continuous Variable ◽  
University Hospital ◽  
Curative Gastrectomy ◽  
Visceral Fat Area ◽  
The Impact ◽  
The Relationship

Background. Visceral obesity is a risk factor for complications after gastrectomy in patients with gastric cancer. However, it is unclear whether postoperative complications decrease with preoperative reduction of visceral fat without the achievement of a nonobese state. This is because previous studies have performed categorical comparisons of obesity and nonobesity. The current study was performed to estimate the impact of the preoperative visceral fat area (VFA) as a continuous variable on postoperative complications after gastrectomy. Methods. Consecutive patients with gastric cancer who underwent curative gastrectomy between June 2006 and August 2017 at the Kyoto University Hospital were included in this retrospective study. The VFA at the level of the umbilicus was measured using preoperative computed tomography. The relationship between postoperative complications and VFA was investigated with univariate and multivariate analyses. Results. total of 566 patients were included in the study. Their mean VFA was 110 ± 58 cm2, and postoperative complications occurred in 121 patients (21.4%). The larger the VFA (<50, 50–99, 100–149, and ≥150 cm2), the higher the incidence of postoperative complications (11%, 14%, 21%, and 38%, respectively, P<0.001). Multivariate logistic regression analyses showed that the VFA was associated with postoperative complications (odds ratio: 1.009, 95% confidence interval (CI): 1.004–1.013, P<0.001), with an incidence of postoperative complications that was 9% (95% CI: 4%–12%) higher for every 10 cm2 increase in the VFA. Conclusion. The incidence of postoperative complications after gastrectomy increases in proportion to an increase in the preoperative VFA.

scholarly journals Impact of Type of Postoperative Complications on Long-Term Survival of Gastric Cancer Patients: Results From a High-Volume Institution in China

2021 ◽  
Vol 11 ◽  
Author(s):  
Hua-Yang Pang ◽  
Lin-Yong Zhao ◽  
Hui Wang ◽  
Xiao-Long Chen ◽  
Kai Liu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Postoperative Complications ◽  
Negative Impact ◽  
Infectious Complications ◽  
Curative Gastrectomy ◽  
Term Survival ◽  
Long Term Survival ◽  
The Impact

BackgroundThis study aimed to evaluate the impact of postoperative complication and its etiology on long-term survival for gastric cancer (GC) patients with curative resection.MethodsFrom January 2009 to December 2014, a total of 1,667 GC patients who had undergone curative gastrectomy were analyzed. Patients with severe complications (SCs) (Clavien–Dindo grade III or higher complications or those causing a hospital stay of 15 days or longer) were separated into a “complication group.” Univariate and multivariate analyses were performed to reveal the relationship between postoperative complications and long-term survival. A 2:1 propensity score matching (PSM) was used to balance baseline parameters between the two groups.ResultsSCs were diagnosed in 168 (10.08%) patients, including different etiology: infectious complications (ICs) in 111 (6.66%) and non-infectious complications (NICs) in 71 (4.26%) patients. Multivariate analysis showed that presence of SCs (P=0.001) was an independent prognostic factor for overall survival, and further analysis by complication type demonstrated that the deteriorated overall survival was mainly caused by ICs (P=0.004) rather than NICs (P=0.068). After PSM, patients with SCs (p=0.002) still had a significantly decreased overall survival, and the presence of ICs (P=0.002) rather than NICs (P=0.067) showed a negative impact on long-term survival.ConclusionSerious complications, particularly of an infectious type, may have a negative impact on overall survival of GC patients. However, additional multicenter prospective studies with larger sample size are required to verify this issue.

Impact of postoperative complications on recurrence in pathological stage II/III gastric cancer patients who received curative resection followed by adjuvant S-1 chemotherapy.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 320-320
Author(s):  
Hayato Watanabe ◽  
Tsutomu Hayashi ◽  
Keisuke Koumori ◽  
Kazuki Kano ◽  
Yota Shimoda ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Postoperative Complications ◽  
Postoperative Complication ◽  
Tumor Location ◽  
Clinicopathological Characteristics ◽  
Cancer Center ◽  
Pathological Stage ◽  
Curative Gastrectomy ◽  
Gastric Cancer Patients ◽  
The Impact

320 Background: Postoperative complications increased recurrence in gastric cancer (GC) patients. However, there was no study evaluating impact of postoperative complication among patients receiving adjuvant chemotherapy. The aim of present study was to investigate the impact of postoperative complications in pStage II/III GC patients who received adjuvant S-1 chemotherapy. Methods: The present study retrospectively examined GC patients who received curative gastrectomy followed by adjuvant S-1 chemotherapy between January 2000 and December 2011 at Kanagawa Cancer Center. The patients with postoperative complications were classified into PC group, and those without postoperative complications were into NC group. Clinicopathological characteristics and recurrence-free survival (RFS) were compared between the groups. Results: 226 patients were included in this study. Postoperative complication occurred in 30 patients (13.3%). Age (Median, range) is significantly higher in NC group (64, 24-86) than in PC group (59, 36-82) (p = 0.033). Total gastrectomy was predominant type of surgery in the PC group (73.3%) than in NC group (52.0%) (p = 0.031). There was no difference in gender, ASA score, tumor location, pathological stage (TNM 7th) and pathological type between two groups. Conclusions: Postoperative complications were an independent risk factor for RFS in pStage II/III GC patients who received curative gastrectomy followed by adjuvant S-1 chemotherapy.

Are quantitative measures of visceral adiposity obtained after neoadjuvant chemoradiation associated with postoperative morbidity in patients with locally advanced rectal cancer?

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 514-514
Author(s):  
Leah E. Hendrick ◽  
Veronica Lippuner ◽  
Tyler Speaks ◽  
Travis S Scharr ◽  
Andrew M Fleming ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Postoperative Complications ◽  
Locally Advanced ◽  
Subcutaneous Fat ◽  
Visceral Obesity ◽  
Neoadjuvant Chemoradiation ◽  
Surgical Morbidity ◽  
Visceral Fat Area ◽  
The Impact ◽  
Metabolic Comorbidities

514 Background: Body mass index (BMI) is an inconsistent predictor of surgical morbidity in cancer patients. Increased visceral obesity measured before neoadjuvant chemoradiation (NCR) has been associated with post-operative morbidity in rectal cancer (RC). We sought to evaluate whether visceral obesity/BMI measured immediately after NCR correlates with postoperative complications in a heterogenous, largely underserved cohort of RC patients. Methods: 116 patients (64% white, 34% black, 2% other) underwent proctectomy for stage II/III RC after NCR. Automated CT segmentation software was used to determine body fat distribution at the L4/L5 level. Patients were classified as obese by BMI (≥ 30 kg/m2) and post-NCR CT measures of adiposity including visceral fat area (VFA; > 100cm2), visceral to subcutaneous fat area ratio (V/S; > 0.4), and perinephric fat thickness (PNF; > median) were obtained. Complications were classified (Clavien-Dindo) into low (1-2) or high (3-4) grade. Associations between measures of adiposity, short-term surgical outcomes and clinicopathologic factors were evaluated with one-way ANOVA, Chi-square, and Fischer’s exact test as appropriate for overall, white, and non-white cohorts. Results: Obese patients by adiposity measures (but not BMI) were more likely to be male by V/S (91.4% vs. 54.3%, p ≤ 0.001) and PNF (62.9% vs. 26.1%, p ≤ 0.001), Caucasian by VFA (mean 135.2 cm2vs. 93.8 cm2, p = 0.002), and have preexisting metabolic comorbidities by VFA and PNF ( p < 0.01). V/S was associated with the presence of key metabolic comorbidities in both white and non-white groups ( p < 0.05). Obesity by V/S but not BMI was associated with development of postoperative complications in the non-white group (65.5% vs. 30.8%, p = 0.049), but not in the overall or white cohorts. Conclusions: V/S as measured after NCR is associated with presence of key metabolic comorbidities in the entire cohort but with postoperative complications only in non-white patients. Given these observations, further evaluation of the impact of socioeconomic factors and change in adiposity between pre- and post-NCR time periods is warranted.

scholarly journals The Role of Visceral Obesity, Sarcopenia and Sarcopenic Obesity on Surgical Outcomes After Liver Resections for Colorectal Metastases

2021 ◽  
Author(s):  
M. Runkel ◽  
T. D. Diallo ◽  
S. A. Lang ◽  
F. Bamberg ◽  
M. Benndorf ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Visceral Obesity ◽  
The Body ◽  
Postoperative Outcomes ◽  
Sarcopenic Obesity ◽  
Colorectal Metastases ◽  
Complication Rates ◽  
The Impact ◽  
Body Compositions

Abstract Background The impact of body compositions on surgical results is controversially discussed. This study examined whether visceral obesity, sarcopenia or sarcopenic obesity influence the outcome after hepatic resections of synchronous colorectal liver metastases. Methods Ninety-four consecutive patients with primary hepatic resections of synchronous colorectal metastases were identified from a single center database between January 2013 and August 2018. Patient characteristics and 30-day morbidity were retrospectively analyzed. Body fat and skeletal muscle were calculated by planimetry from single-slice CT images at the level of L3. Results Fifty-nine patients (62.8%) underwent minor hepatectomies, and 35 patients underwent major resections (37.2%). Postoperative complications occurred in 60 patients (62.8%) including 35 patients with major complications (Clavien–Dindo grade III–V). The mortality was nil at 30 days and 2.1% at 90 days. The body mass index showed no influence on postoperative outcomes (p = 1.0). Visceral obesity was found in 66 patients (70.2%) and was significantly associated with overall and major complication rates (p = .002, p = .012, respectively). Sarcopenia was observed in 34 patients (36.2%) without a significant impact on morbidity (p = .461), however, with longer hospital stay. Sarcopenic obesity was found in 18 patients (19.1%) and was significantly associated with postoperative complications (p = .014). Visceral obesity, sarcopenia and sarcopenic obesity were all identified as significant risk factors for overall postoperative complications. Conclusion Visceral obesity, sarcopenic obesity and sarcopenia are independent risk factors for overall complications after resections of CRLM. Early recognition of extremes in body compositions could prompt to perioperative interventions and thus improve postoperative outcomes.

scholarly journals Association between Serum Concentration of Carotenoid and Visceral Fat

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 912
Author(s):  
Mai Matsumoto ◽  
Hiroyuki Suganuma ◽  
Naoki Ozato ◽  
Sunao Shimizu ◽  
Mitsuhiro Katashima ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Visceral Fat ◽  
Fruits And Vegetables ◽  
Beta Carotene ◽  
The Body ◽  
Healthy Individuals ◽  
Health Checkup ◽  
Visceral Fat Area ◽  
The Relationship ◽  
Aomori Prefecture

Consumption of fruits and vegetables rich in carotenoids has been widely reported to prevent cardiovascular diseases. However, the relationship between serum carotenoid concentrations and visceral fat area (VFA), which is considered a better predictor of cardiovascular diseases than the body-mass index (BMI) and waist circumference, remains unclear. Therefore, we examined the relationship in healthy individuals in their 20s or older, stratified by sex and age, to compare the relationship between serum carotenoid concentrations and VFA and BMI. The study was conducted on 805 people, the residents in Hirosaki city, Aomori prefecture, who underwent a health checkup. An inverse relationship between serum carotenoid concentrations and VFA and BMI was observed only in women. In addition, the results were independent of the intake of dietary fiber, which is mainly supplied from vegetables as well as carotenoids. This suggests that consumption of a diet rich in carotenoids (especially lutein and beta-carotene) is associated with lower VFA, which is a good predictor of cardiovascular disease, especially in women. This study is the first to comprehensively evaluate the association between serum carotenoid levels and VFA in healthy individuals.

Prospective Assessment of Helicobacter Pylori Infection and Gastric Pathologies in Sidi Bel Abbes region, Western Algeria

2018 ◽  
Vol 7 (5) ◽  
pp. 217-224
Author(s):  
Zouaouia Chama ◽  
Khedoudj Kanoun ◽  
Fatima Zohra Elkadi ◽  
Kara Turqui Douidi ◽  
Noria Harir ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Histological Study ◽  
Helicobacter Pylori Infection ◽  
University Hospital ◽  
Infection Prevalence ◽  
Gastric Diseases ◽  
Number Of Patients ◽  
H Pylori ◽  
The Impact

Helicobacter pylori infection concerns half of the world’s population, mainly in developing countries. It causes several gastrodudenal pathologies such as gastritis, ulcer and gastric adenocarcinoma. The aim of our study was to determine the prevalence of H.pylori infection and to assess the impact of different epidemiological factors as well as principal gastric diseases associ-ated to this infection. We underwent a prospective study during 18 months (month 2016-month 2017) which implicated 201 symptomatic patients for gastric fiboptic endoscopy at the level of Sidi Bel Abbes University hospital. We collected patients’ biopsies to perform a histological study and H. pylori culture. H. pylori identification was carried out based on bacteriological and biochemical analysis. The middle age of our population was (47.29 ±15.97ans) and the sex-ratio =0,8. The global prevalence of Helicobacter pylori infection is of 61.2% (123/201). This rate, after a statistic analysis, seems to be significantly related to age. It is particularly high especially for patients belonging to age range (20-30)-(51-60) years. The gender did not affect the infection prevalence that is more frequent in the gastritis case. We noticed also that HP infection prevalence was important in SBA the hospital. The range age (20-30)-(51-60) years had the highest prevalence of H. pylori and of gastritis which might be a risky ground of gastric cancer appearance. The ulcer pathology maximal rate concerned the group of 51 to 60 years. Above this age, this rate dropped whereas the number of patients suffering from gastric cancer, which presents an important rate in our study, increase for the group of 61-70 years.

scholarly journals Cardiorespiratory Fitness and Body Composition in Postmenopausal Women

2014 ◽  
Vol 43 (1) ◽  
pp. 139-148 ◽  
Author(s):  
Helena Moreira ◽  
Betânia Passos ◽  
Josiane Rocha ◽  
Vivianne Reis ◽  
André Carneiro ◽  
...  
Keyword(s):  
Body Composition ◽  
Oxygen Uptake ◽  
Metabolic Rate ◽  
Postmenopausal Women ◽  
Aerobic Fitness ◽  
Basal Metabolic Rate ◽  
Visceral Fat ◽  
Central Adiposity ◽  
Visceral Fat Area ◽  
The Relationship

Abstract The object of the study was to analyze the relationship between aerobic fitness and body composition in postmenopausal women. We hypothesized that postmenopausal women that had higher adiposity had lower cardiorespiratory capacity, regardless of the characteristics of menopause. The sample included 208 women (57.57 ± 6.62 years), whose body composition and the basal metabolic rate were evaluated by octopolar bioimpedance (InBody 720) and the oxygen uptake by the modified Bruce protocol. Most of the sample showed obesity and a high visceral fat area. The visceral fat area and the basal metabolic rate explained 30% of the variation of oxygen uptake, regardless of age, time, nature or hormone therapy. The values of the latter variables were reduced in the presence of high central adiposity (-6.16 ml/kg/min) and the basal metabolic rate of less than 1238 kcal/day (-0.18 ml/kg/min). The women with oxygen uptake above 30.94 ml/kg/min showed lower values of total and central adiposity when compared with other groups. With an increase of aerobic fitness, there was a growing tendency of the average values of the soft lean mass index, with differences between the groups low-high and moderate-high. These results suggest worsening of the cardiorespiratory condition with an increase of central adiposity and a decrease of the BMR, regardless of age and menopause characteristics.

scholarly journals Decrease in Serum Urate Level Is Associated With Loss of Visceral Fat in Male Gout Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Zijing Ran ◽  
Xiaomei Xue ◽  
Lin Han ◽  
Robert Terkeltaub ◽  
Tony R. Merriman ◽  
...  
Keyword(s):  
Regression Model ◽  
Visceral Fat ◽  
Multiple Linear Regression Model ◽  
Serum Urate ◽  
Multiple Regression Model ◽  
Final Visit ◽  
Visceral Fat Area ◽  
Serum Urate Level ◽  
Lowering Therapy ◽  
The Relationship

ObjectiveTo clarify the relationship between serum urate (SU) decrease and visceral fat area (VFA) reduction in patients with gout.MethodsWe retrospectively analyzed 237 male gout patients who had two sets of body composition and metabolic measurements within 6 months. Subjects included had all been treated with urate-lowering therapy (ULT) (febuxostat 20–80 mg/day or benzbromarone 25–50 mg/day, validated by the medical record). All patients were from the specialty gout clinic of The Affiliated Hospital of Qingdao University. The multiple linear regression model evaluated the relationship between change in SU [ΔSU, (baseline SU) – (final visit SU)] and change in VFA [ΔVFA, (baseline VFA) – (final visit VFA)].ResultsULT resulted in a mean (standard deviation) decrease in SU level (464.22 ± 110.21 μmol/L at baseline, 360.93 ± 91.66 μmol/L at the final visit, p &lt;0.001) accompanied by a decrease in median (interquartile range) VFA [97.30 (81.15–118.55) at baseline, 90.90 (75.85–110.05) at the final visit, p &lt; 0.001]. By multiple regression model, ΔSU was identified to be a significant determinant variable of decrease in VFA (beta, 0.302; p = 0.001).ConclusionsThe decrease in SU level is positively associated with reduced VFA. This finding provides a rationale for clinical trials to affirm whether ULT promotes loss of visceral fat in patients with gout.

scholarly journals Phenotypes of Sarcopenic Obesity: Exploring the Effects on Peri-Muscular Fat, the Obesity Paradox, Hormone-Related Responses and the Clinical Implications

Geriatrics ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 8 ◽  
Author(s):  
Tariq A. Alalwan
Keyword(s):  
Postoperative Complications ◽  
Visceral Fat ◽  
Polycystic Ovary ◽  
Subcutaneous Fat ◽  
Visceral Obesity ◽  
Obesity Paradox ◽  
Sarcopenic Obesity ◽  
Clinical Implications ◽  
Hormonal Responses ◽  
Definition Of

Sarcopenic obesity combines the words sarcopenia and obesity. This definition of obesity should be better differentiated between visceral and subcutaneous fat phenotypes. For this reason, this review lays the foundation for defining the subcutaneous and the visceral fat into the context of sarcopenia. Thus, the review aims to explore the missing links on pathogenesis of visceral fat and its relationship on age: defining the peri-muscular fat as a new entity and the subcutaneous fat as a first factor that leads to the obesity paradox. Last but not least, this review underlines and motivates the mechanisms of the hormonal responses and anti-inflammatory adipokines responsible for the clinical implications of sarcopenic visceral obesity, describing factor by factor the multiple axis between the visceral fat-sarcopenia and all mortality outcomes linked to cancer, diabetes, cardiovascular diseases, cirrhosis, polycystic ovary, disability and postoperative complications.

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