内脏脂肪面积联合性别预测腹腔镜胃旁路手术时长的临床价值OA
Clinical value of visceral fat area combined with sex in predicting operative time of laparoscopic Roux-en-Y gastric bypass
目的 探讨内脏脂肪面积(VFA)对腹腔镜Roux-en-Y胃旁路术(LRYGB)手术时长的预测价值,为优化肥胖合并2型糖尿病(T2DM)患者的手术规划提供依据.方法 回顾性分析47例肥胖T2DM患者(BMI≥27.5 kg/m2)的临床资料,通过人体成分分析仪(Inbody230)测定术前VFA等指标,记录手术时长及并发症.以15例非肥胖T2DM患者(BMI＜27.5 kg/m2)为对照,采用Spearman相关分析VFA与手术时长的相关性,多因素线性回归识别影响因素,ROC曲线确定VFA预测手术时长及联合性别预测的效能.结果 肥胖组VFA显著高于对照组(P＜0.05),且女性VFA高于男性[(131.07±34.44)cm2 vs.(112.79±15.44)cm2,P=0.029];手术时长与VFA呈显著正相关(r=0.443,P＜0.01),多因素回归显示VFA是手术时长的独立影响因素(P＜0.05);VFA预测手术时长的ROC曲线下面积(AUC)为0.689(95％CI:0.538～0.840,敏感度91.67％,特异度39.13％);联合性别预测时AUC提升至0.808(95％CI:0.684～0.932,敏感度66.67％,特异度82.67％).结论 VFA是LRYGB手术时长的独立预测因子,联合性别可显著提高预测准确性.建议术前将VFA(尤其女性患者)纳入风险评估体系,以优化手术资源配置及临床路径管理.
Objective To investigate the predictive value of visceral fat area(VFA)for operative time in laparo-scopic Roux-en-Y gastric bypass(LRYGB)and to evaluate whether combining VFA with sex improves prediction accu-racy,thereby providing evidence for optimized surgical planning in obese patients with type 2 diabetes mellitus(T2 DM).Methods Clinical data of 47 obese patients with T2DM(BMI ≥27.5 kg/m2)undergoing LRYGB were retrospectively analyzed.Preoperative VFA and related body composition parameters were measured using a bioelectrical impedance ana-lyzer(InBody 230).Operative time and perioperative complications were recorded.Fifteen non-obese T2DM patients(BMI＜27.5 kg/m2)served as controls.Spearman correlation analysis was performed to assess the relationship between VFA and operative time.Multivariate linear regression was used to identify independent influencing factors.Receiver oper-ating characteristic(ROC)curves were constructed to evaluate the predictive performance of VFA alone and in combina-tion with sex.Results VFA was significantly higher in the obese group than in the control group(P＜0.05),and female patients had a higher VFA than male patients[(131.07±34.44)cm2 vs.(112.79±15.44)cm2,P=0.029].Opera-tive time was positively correlated with VFA(r=0.443,P＜0.01).Multivariate linear regression analysis identified VFA as an independent predictor of operative time(P＜0.05).The area under the ROC curve(AUC)for VFA alone in pre-dicting prolonged operative time was 0.689(95％CI:0.538-0.840),with a sensitivity of 91.67％and a specificity of 39.13％.When combined with sex,the AUC increased to 0.808(95％CI:0.684-0.932),with a sensitivity of 66.67％and a specificity of 82.67％.Conclusion Visceral fat area is an independent predictor of operative time in LRYGB.Combining VFA with sex significantly improves predictive accuracy.Incorporating preoperative VFA assessment,particularly in female patients,into risk stratification may facilitate better surgical resource allocation and optimization of clinical pathways.
曾松华;黄红艳;汪蕾;吴慧;吴良平
中国人民解放军南部战区总医院普通外科(广东 广州 510030)广州中医药大学金沙洲医院普外减重代谢外科(广东 广州 510168)广州中医药大学金沙洲医院普外减重代谢外科(广东 广州 510168)广州中医药大学金沙洲医院普外减重代谢外科(广东 广州 510168)广州中医药大学金沙洲医院普外减重代谢外科(广东 广州 510168)
医药卫生
内脏脂肪面积腹腔镜Roux-en-Y胃旁路术手术时长预测价值2型糖尿病肥胖症
visceral fat arealaparoscopic Roux-en-Y gastric bypassoperation timepredictive valuetype 2 diabetesobesity
《广东医学》 2026 (1)
29-33,5
广东省医学科学技术研究基金(C2025012)
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