Anthropometric and bioimpedansometric predictors of postoperative complications in patients with gastric and cardioesophageal junction cancers

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Abstract

BACKGROUND: Among the most common intra-abdominal complications of surgical treatment of gastric and cardioesophageal junction cancers are acute postoperative pancreatitis and abdominal abscesses.

AIM: Identification and study of anthropometric and bioimpedansometric predictors of the complicated course of the postoperative period in patients with gastric and cardioesophageal junction cancers.

MATERIAL AND METHODS: 250 patients with gastric and cardioesophageal junction cancers, 123 men and 127 women, were examined. All subjects underwent radical surgical treatment. In the postoperative period, postoperative complications were recorded in 40 patients. All subjects underwent anthropometric and bioimpedance examination. Height and body weight, transverse diameter of the chest, width of the shoulders and pelvis, waist and hip circumference, and body morphotype were determined. Bioimpedansometric examination was carried out before surgery and in the postoperative period using a domestic hardware and software complex with determination of the body component composition and the phase angle value. The phase angle of impedance reflected the metabolic rate in the body. The results were statistically processed using descriptive statistics methods. The Shapiro–Francia, Kolmogorov–Smirnov tests, Student's t-test, Mann–Whitney test, and the logistic regression method were used. Differences were considered statistically significant at p <0.05.

RESULTS: Women of the gynecomorphic body type were characterized by a significant decrease in the relative values of active cellular and skeletal muscle mass (p=0.001; p=0.001), and the phase angle value until 12–14 days after surgery (p=0.001). Men of the andromorphic body type were characterized by a significant decrease in the relative values of active cell mass (p=0.001) and the phase angle until 12–14 days after surgery (p=0.001). In women of a gynecomorphic morphotype, the likelihood of postoperative complications was 4 times higher than in women of an andromorphic morphotype (p=0.001). Representatives of the mesomorphic body morphotype of both sexes were characterized by stable bioimpedance measurements during the entire postoperative period.

CONCLUSION: Low values of the phase angle in men and women, as well as the classic gynecomorphic body type in women can be used in oncoabdominal surgery as predictors of a high risk postoperative complications developing in patients with gastric and cardioesophageal junction cancers.

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About the authors

Ekaterina A. Gorbunova

Krasnoyarsk State Medical University named after V.F. Voino-Yasenetsky; Krasnoyarsk Regional Clinical Oncology Dispensary named after A.I. Kryzhanovsky

Author for correspondence.
Email: opium-100@yandex.ru
ORCID iD: 0000-0002-5297-5980
SPIN-code: 8525-7253

M.D., Cand. Sci. (Med.), Assistant, Depart. of Oncology and Radiation Therapy with a Postgraduate Course; Head of Depart.

Russian Federation, Krasnoyarsk; Krasnoyarsk

Sergei S. Startsev

Pacific State Medical University; Sakhalin Regional Oncology Center

Email: sakhstar2010@mail.ru
ORCID iD: 0009-0003-0749-0778

M.D., Lecturer, Institute of professional Development; Head Physician

Russian Federation, Vladivostok; Yuzhno-Sakhalinsk

Ivan P. Safontsev

Krasnoyarsk State Medical University named after V.F. Voino-Yasenetsky; Krasnoyarsk Regional Clinical Oncology Dispensary named after A.I. Kryzhanovsky

Email: safoncev@gmail.ru
ORCID iD: 0000-0002-8177-6788
SPIN-code: 1548-5565

M.D., Cand. Sci. (Med.), Assoc. Prof., Depart. of Oncology and Radiation Therapy with a Postgraduate Course; Deputy Head Physician

Russian Federation, Krasnoyarsk; Krasnoyarsk

Ruslan A. Zukov

Krasnoyarsk State Medical University named after V.F. Voino-Yasenetsky; Krasnoyarsk Regional Clinical Oncology Dispensary named after A.I. Kryzhanovsky

Email: zukov_rus@mail.ru
ORCID iD: 0000-0002-7210-3020
SPIN-code: 3632-8415
Scopus Author ID: 6508181003

M.D., Prof., Head of Depart., Depart. of Oncology and Radiation Therapy with a Postgraduate Course; Head Physician

Russian Federation, Krasnoyarsk; Krasnoyarsk

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2. Fig. 1. Dynamics of changes in the relative values of active cell mass (AKM) and skeletal muscle mass of men in the postoperative period. А. Men of andromorphic body type. Б. Men of gynecomorphic body type. В. Men of mesomorphic body type. *Statistically significant chan¬ges (p_value <0.05)

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3. Fig. 2. Dynamics of changes in the relative values of active cell mass (AКM) and skeletal muscle mass of women in the postoperative pe¬riod. А. Women of gynecomorphic body type. Б. Women of andromorphic body type. В. Women of mesomorphic body type. *Statistically significant changes (p_value <0.05)

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4. Fig. 3. Dynamic of changes in the phase angle in patients with gastric cancer in the postoperative period, depending on the body morphotype: А — men; Б — women. *Statistically significant changes (p_value <0.05)

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