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. 2024 Oct;52(10):3000605241282077.
doi: 10.1177/03000605241282077.

Visceral to subcutaneous fat area ratio predicts early postoperative small bowel obstruction after total gastrectomy for cardia cancer

Changfeng Fan  1 , Hailu Yang  2
Affiliations

Visceral to subcutaneous fat area ratio predicts early postoperative small bowel obstruction after total gastrectomy for cardia cancer

Changfeng Fan et al. J Int Med Res. 2024 Oct.

Abstract

Objective: We aimed to investigate the relationship between the visceral to subcutaneous fat area ratio (V/S ratio) and incidence of early postoperative small bowel obstruction (EPSBO) following total gastrectomy for cardia cancer.

Methods: We conducted a retrospective analysis among patients with cardia cancer who underwent elective total gastrectomy with esophagojejunostomy Roux-en-Y anastomosis at Nanjing Yimin Hospital between November 2019 and April 2024. Preoperative, intraoperative, and postoperative factors were meticulously monitored. The V/S ratio was calculated using computed tomography scans at the umbilical level with Slice-O-Matic software (Tomovision, Montreal, Canada). Statistical analyses included logistic regression and receiver operating characteristic (ROC) curve analysis.

Results: Among 175 patients, 27 (15.4%) developed EPSBO. The V/S ratio was significantly higher in the EPSBO group (1.76 ± 1.05 vs. 1.01 ± 0.54). Logistic regression identified the V/S ratio as a significant predictor of EPSBO (odds ratio [OR] = 1.612, 95% [CI]: 1.102-1.605). ROC curve analysis demonstrated high sensitivity (92%) and specificity (100%) for the V/S ratio in predicting EPSBO, with a 0.83 AUC.

Conclusions: Our findings indicated a higher V/S ratio was a significant predictor of EPSBO following total gastrectomy for cardia cancer. Preoperative assessment of the V/S ratio can inform risk stratification and guide targeted interventions to improve postoperative outcomes.

Keywords: Visceral to subcutaneous fat ratio; cardia cancer; early postoperative small bowel obstruction; postoperative complication; total gastrectomy; visceral obesity.

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Conflict of interest statement

Declaration of conflicting interestThe authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
ROC analysis of risk factors for EPSBO prediction. ROC curves for anastomotic leakage, V/S ratio, duration of operation, and VFA in predicting EPSBO in patients receiving elective total gastrectomy with esophagojejunostomy Roux-en-Y anastomosis. ROC, receiver operating characteristic; VFA, visceral fat area; EPSBO, early postoperative small bowel obstruction; V/S ratio, visceral to subcutaneous fat area ratio.
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