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The impact of visceral obesity on surgical outcomes of laparoscopic surgery for colon cancer

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Abstract

Purpose

Although obesity is considered as a risk factor for postoperative morbidity in abdominal surgery, its effect on the outcomes of laparoscopic-assisted colectomy (LAC) is still unclear. The technical difficulty and risk factor for postoperative complication in LAC are thought to be influenced by visceral obesity. The aim of this prospective study was to evaluate the impact of visceral fat on the surgical outcomes of LAC.

Methods

Between April 2005 and December 2010, consecutive patients with preoperatively diagnosed colon cancer, excluding medium and low rectal cancer, who underwent LAC, were enrolled. Their visceral fat area (VFA) and body mass index (BMI) were prospectively collected. The VFA was assessed by Fat Scan software. The patients were classified into two groups as follows: VFA nonobese with VFA <100 cm2 (VNO) and VFA obese with VFA ≧100 cm2 (VO). The predictive factors for surgical complications of LAC were evaluated by univariate and logistic regression analyses.

Results

A total of 338 consecutive patients were enrolled in this study. Of the 338 patients, 194 (57.4 %) and 138 (42.6 %) were classified into the VNO and VO groups, respectively. Logistic regression analysis showed that high BMI (≧25 kg/m2) and VO independently predicted the incidence of overall postoperative complications (p = 0.040 and 0.007, respectively). VO was more highly related to the incidence of overall postoperative complications, anastomotic leakage (p = 0.021), and surgical site infection (SSI) (p = 0.013) than high BMI.

Conclusions

VFA is a more useful parameter than BMI in predicting surgical outcomes after LAC.

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Disclosures

Jun Watanabe, Kenji Tatsumi, Mitsuyoshi Ota, Yusuke Suwa, Shinsuke Suzuki, Akira Watanabe, Atsushi Ishibe, Kazuteru Watanabe, Hirotoshi Akiyama, Yasushi Ichikawa, Satoshi Morita, and Itaru Endo have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan

    Jun Watanabe, Kenji Tatsumi, Yusuke Suwa, Shinsuke Suzuki, Akira Watanabe, Kazuteru Watanabe, Hirotoshi Akiyama, Yasushi Ichikawa & Itaru Endo

  2. Department of Surgery, Gastroenterological Center, Yokohama City University, Yokohama, Japan

    Mitsuyoshi Ota & Atsushi Ishibe

  3. Department of Biostatistics and Epidemiology, Yokohama City University, Yokohama, Japan

    Satoshi Morita

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  1. Jun Watanabe
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Correspondence to Jun Watanabe.

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Watanabe, J., Tatsumi, K., Ota, M. et al. The impact of visceral obesity on surgical outcomes of laparoscopic surgery for colon cancer. Int J Colorectal Dis 29, 343–351 (2014). https://doi.org/10.1007/s00384-013-1803-9

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