Abstract:

Objective

To analyze the relationship between abdominal morphological CT parameters and blood loss during total laparoscopic gastrectomy.

Methods

80 patients with gastric cancer admitted from January 2022 to January 2024 underwent laparoscopic total gastrectomy.SPSS 21.0 statistical software was used to analyze the data， and the counting data were tested in line 2.Measurement data were represented by （x± s ）， and independent sample t test was performed.Logistic regression model was used to analyze the influencing factors of blood loss during laparoscopic total gastrectomy.P＜0.05 was considered statistically significant.

Results

All patients successfully completed laparoscopic total gastrectomy and obtained R0 resection.Preoperative CT measurements of abdominal visceral fat area （VFA）， transverse abdominal diameter（TD）， minimum distance from pancreas to anterior abdominal skin （PAAD）， and substernal Angle （LSA） were 100 （56.3， 129.4） cm²， 30 （14.2， 46.5） cm， 59.7 （20.0）， respectively.119.7） mm， 74.2 （46.1， 106.9）°.The intraoperative blood loss of VFA≥100cm²， TD≥30cm， PAAD≥59.7mm， LSA≥74.2° group was significantly higher than that of the other group， and the difference was statistically significant （P＜0.05）.Logistic regression analysis shows: Operative time， BMI， VFA， TD， PAAD and LSA were correlated with intraoperative blood loss（P＜0.05）， and operative time， VFA （≥100cm²）， PAAD （≥59.7mm） and LSA （≥74.2°） were independent risk factors affecting intraoperative blood loss （P＜0.05）.

Conclusion

In laparoscopic total gastrectomy， when the abdominal morphology CT parameters VFA≥100cm²， PAAD≥59.7mm， LSA≥74.2°， the difficulty of surgery is increased， and intraoperative bleeding should be highly vigilant.

Key words: Gastrectomy, Laparoscopes, Abdominal Morphology, CT Measurement, Blood Loss, Surgical