Impact of Sarcopenic Obesity on Surgical Site Infection after Laparoscopic Total Gastrectomy

• Published in: Annals of surgical oncology Vol. 23; no. Suppl 4; pp. 524 - 531
• Main Authors: Nishigori, Tatsuto, Tsunoda, Shigeru, Okabe, Hiroshi, Tanaka, Eiji, Hisamori, Shigeo, Hosogi, Hisahiro, Shinohara, Hisashi, Sakai, Yoshiharu
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.08.2016; Springer Nature B.V
• Subjects: Gastrointestinal Oncology; Medicine; Medicine & Public Health; Oncology; Surgery; Surgical Oncology; Gastric Cancer; Surgical Site Infection; Laparoscopic Gastrectomy; Pancreatic Fistula; Skeletal Muscle Mass
• ISSN: 1068-9265; 1534-4681
• DOI: 10.1245/s10434-016-5385-y

Background The critical risk factors for surgical site infection (SSI) after laparoscopic total gastrectomy (LTG) remain unclear. We analyzed the association between body composition and SSI after LTG. Methods We performed a retrospective study of patients with gastric cancer who underwent LTG between March 2006 and October 2014 at Kyoto University Hospital, Japan. Visceral fat area and skeletal muscle mass were assessed from preoperative computed tomography scans to define sarcopenia and obesity. Patients were classified into one of four body composition categories according to the presence or absence of sarcopenia or obesity. The incidence of SSI was compared between the four body composition categories. Results Of the 157 eligible patients, 45 (24 %) fulfilled the criteria for sarcopenic obesity, 28 (18 %) for nonsarcopenic obesity, 52 (33 %) for sarcopenic nonobesity, and 32 (20 %) for nonsarcopenic nonobesity. Thirty-two patients developed SSI (overall incidence rate, 20 %). The incidence of SSI in each body composition category was 33, 25, 13, and 9 %, respectively ( P  = 0.03). Multivariate logistic regression analysis showed that only sarcopenic obesity was associated with an increased incidence of SSI (odds ratio 4.59, 95 % confidence interval 1.18–17.78, P  = 0.028). Conclusions Sarcopenic obesity is an independent risk factor for the development of SSI after LTG.