Body mass index is a risk factor for postoperative morbidity after laparoscopic hepatectomy of hepatocellular carcinoma: a multicenter retrospective study.

IF 2.7 3区医学 Q3 ONCOLOGY Journal of Cancer Research and Clinical Oncology Pub Date : 2024-10-05 DOI:10.1007/s00432-024-05979-w

Shiye Yang, Haishun Ni, Aixian Zhang, Jixiang Zhang, Huoqi Liang, Xing Li, Jiayi Qian, Hong Zang, Zhibing Ming

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引用次数: 0

Abstract

Purpose: The aim of this study was to determine whether preoperative body mass index (BMI) was associated with postoperative morbidity after laparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC).

Methods: A total of three groups of patients were categorized based on preoperative BMI: low-BMI (≤ 18.4 kg/m²), normal-BMI (18.5-24.9 kg/m²) and high-BMI (≥ 25.0 kg/m²). Baseline clinicopathological characteristics, operative variables, and postoperative 30-day mortality and morbidity were recorded and compared among the three groups. The independent risk factors for postoperative morbidity, including surgical site infection (SSI), were identified using univariate and multivariate analyses.

Results: Among 226 included patients, 20 (8.8%), 122 (54%), and 84 (37.2%) patients had low, normal, and high BMI, respectively. There were no significant differences in postoperative 30-day mortality rates in patients with low BMI and high BMI compared with those with normal BMI (5% and 1.2% vs. 0%, P = 0.141 and P = 0.408, respectively). However, postoperative morbidity rates were significantly higher in patients with low BMI and high BMI compared to those with normal BMI (40% and 32.1% vs. 17.2%, P = 0.032 and P = 0.020, respectively). According to multivariate analysis, both low and high BMI were independent risk factors of increased postoperative morbidity (OR: 5.03, 95% CI: 1.02-25.6, P = 0.047, and OR: 4.53, 95% CI: 1.75-12.8, P = 0.003, respectively). Low and high BMI were also identified as independent risk factors of increased postoperative SSI rates (OR: 6.25, 95% CI: 1.60-23.8, P = 0.007, and OR: 2.89, 95% CI: 1.04-8.77, P = 0.047, respectively).

Conclusion: A higher incidence of postoperative morbidity including SSI after LLR for HCC was found in low-BMI and high-BMI patients compared to normal-BMI patients.

Clinical trials registration: Not applicable because this is a retrospective observational study.

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体重指数是腹腔镜肝癌切除术后发病率的风险因素：一项多中心回顾性研究。

目的：本研究旨在确定腹腔镜肝切除术（LLR）术前体重指数（BMI）是否与肝细胞癌（HCC）术后发病率相关：根据术前 BMI 将患者分为三组：低 BMI（≤ 18.4 kg/m2）、正常 BMI（18.5-24.9 kg/m2）和高 BMI（≥ 25.0 kg/m2）。记录并比较了三组患者的基线临床病理特征、手术变量、术后 30 天死亡率和发病率。通过单变量和多变量分析确定了术后发病率（包括手术部位感染（SSI））的独立风险因素：在纳入的 226 例患者中，体重指数较低、正常和较高的患者分别为 20 例（8.8%）、122 例（54%）和 84 例（37.2%）。低体重指数和高体重指数患者的术后 30 天死亡率与正常体重指数患者相比无明显差异（分别为 5% 和 1.2% 对 0%，P = 0.141 和 P = 0.408）。然而，低体重指数和高体重指数患者的术后发病率明显高于体重指数正常者（分别为 40% 和 32.1% 对 17.2%，P = 0.032 和 P = 0.020）。根据多变量分析，低体重指数和高体重指数都是术后发病率增加的独立风险因素（OR：5.03，95% CI：1.02-25.6，P = 0.047；OR：4.53，95% CI：1.02-25.6，P = 0.047）：4.53，95% CI：1.75-12.8，P = 0.003）。低体重指数和高体重指数也是术后 SSI 发生率增加的独立风险因素（OR：6.25，95% CI：1.60-23.8，P = 0.007；OR：2.89，95% CI：1.04-8.77，P = 0.047）：结论：与正常体重指数的患者相比，低体重指数和高体重指数的患者在接受 LLR 治疗 HCC 后包括 SSI 在内的术后发病率更高：临床试验注册：不适用，因为这是一项回顾性观察研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cancer Research and Clinical Oncology 医学-肿瘤学

CiteScore

4.00

自引率

2.80%

发文量

577

审稿时长

2 months

期刊介绍： The "Journal of Cancer Research and Clinical Oncology" publishes significant and up-to-date articles within the fields of experimental and clinical oncology. The journal, which is chiefly devoted to Original papers, also includes Reviews as well as Editorials and Guest editorials on current, controversial topics. The section Letters to the editors provides a forum for a rapid exchange of comments and information concerning previously published papers and topics of current interest. Meeting reports provide current information on the latest results presented at important congresses. The following fields are covered: carcinogenesis - etiology, mechanisms; molecular biology; recent developments in tumor therapy; general diagnosis; laboratory diagnosis; diagnostic and experimental pathology; oncologic surgery; and epidemiology.