Impact of visceral fat distribution on postoperative complications in high-aged patients undergoing gastric cancer surgery: A cross-sectional study.

BACKGROUND

The annual incidence of gastric cancer in elderly patients is increasing. Despite the continuous progress in treatment methods, the prognosis of elderly patients remains poor, and postoperative complications are frequent. Obesity is believed to be associated with the risk of gastric cancer and postoperative prognosis; however, the effect of visceral fat distribution on postoperative complications of gastric cancer in elderly patients remains unclear.

AIM: To explore the effect of visceral fat distribution on postoperative complications of gastric cancer in elderly patients.

METHODS

A total of 163 elderly patients treated at the Affiliated Longyan First Hospital of Fujian Medical University after radical gastrectomy between January 2021 and January 2024 were enrolled. The patients' visceral and subcutaneous fat distributions were measured and divided into a high visceral fat area (VFA-H) group and a low visceral fat area (VFA-L) group, with a critical value of 100 cm2. The t-test and χ 2 test were used to calculate and analyze the relationship between visceral fat area (VFA) and complications. Independent risk factors for postoperative complications were analyzed using binary logistic regression analysis.

RESULTS

Compared with the VFA-L group, the incidence of postoperative complications was higher in the VFA-H group (27.8% vs 6.4%, P < 0.001), and the operation time was longer (268.55 ± 63.41 vs 224.31 ± 51.89, P < 0.001). The amount of blood loss was more (163.77 ± 105.27 mL vs 127.93 ± 98.26 mL, P < 0.001). Logistic regression analysis showed that VFA [odds ratio (OR): 2.597, 95%CI: 1.479-4.853, P = 0.004], total fat area (OR: 1.655, 95%CI: 1.076-4.040, P = 0.013), and the visceral subcutaneous fat area ratio (OR: 2.046, 95%CI: 1.196-5.640, P = 0.008) were independent risk factors for postoperative complications.

CONCLUSION

This study showed that postoperative complications are closely related to fat distribution in elderly patients with gastric cancer undergoing gastrectomy. A high VFA is associated by a high incidence of postoperative complications.