Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 14, 2025; 31(22): 105201
Published online Jun 14, 2025. doi: 10.3748/wjg.v31.i22.105201
Impact of visceral fat distribution on postoperative complications in high-aged patients undergoing gastric cancer surgery: A cross-sectional study
Wen-Feng Li, Chang-Rong Que, Dong-Bo Xu, Ping Li
Wen-Feng Li, Chang-Rong Que, Dong-Bo Xu, Department of Gastrointestinal and Anus Surgery, The Affiliated Longyan First Hospital of Fujian Medical University, Longyan 364000, Fujian Province, China
Ping Li, Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350000, Fujian Province, China
Co-corresponding authors: Dong-Bo Xu and Ping Li.
Author contributions: The concept of this study was jointly proposed by Li WF and Xu DB, Li P who participated in data collection; Li WF drafted the initial draft; Xu DB and Que CR contributed to the formal analysis of this study; Li WF guided the research, methodology, and visualization of the manuscript; Li WF, Xu DB, Li P and Que CR participated in this study and validated it by jointly reviewing and editing the manuscript. Xu DB and Li P were listed as co-corresponding authors because they played a crucial role in the design, implementation and writing of the research paper. Xu DB and Li P were the core members of the research, providing significant support respectively in data analysis, methodological guidance, and academic feedback. They not only provided valuable suggestions and guidance throughout the research process, but also participated in the multiple revisions and improvements of the paper. Therefore, in view of their in-depth participation and contribution in the research, both parties were jointly designated as corresponding authors.
Institutional review board statement: This study has been reviewed and approved by the Ethics Committee of the First Affiliated Hospital of Longyan City, Fujian Medical University, No. LYFH-LL-022.
Informed consent statement: This study has obtained the consent of the patients and their guardians, who have signed the consent form.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Due to privacy concerns and confidentiality agreements, the datasets generated and analyzed in the current study are not publicly available. However, if access is required, please contact the corresponding author and submit a reasonable request at xdb2292388@126.com, and the data can be provided.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dong-Bo Xu, MD, Department of Gastrointestinal and Anus Surgery, The Affiliated Longyan First Hospital of Fujian Medical University, No. 1 Lianzhuang South Road, Xinluo District, Longyan 364000, Fujian Province, China. xdb2292388@126.com
Received: April 15, 2025
Revised: May 6, 2025
Accepted: June 3, 2025
Published online: June 14, 2025
Processing time: 57 Days and 18.7 Hours
Abstract
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 χ2 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.

Keywords: Visceral fat distribution; Gastric cancer; Complications; Risk factor; Cross-sectional study

Core Tip: Postoperative complications were closely related to visceral fat content in elderly patients with gastric cancer who underwent gastrectomy. High visceral fat area results in increased intraoperative blood loss, longer operation time, and a higher incidence of postoperative complications. Clinicians should pay close attention to the relevant indicators before surgery and improve the nutritional status of patients to minimize the risk of postoperative complications and improve prognosis.