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01-03-2018 | Original Article

The effect of metabolic syndrome on postoperative outcomes following laparoscopic colectomy

Authors: A. Zarzavadjian Le Bian, C. Denet, N. Tabchouri, H. Levard, R. Besson, T. Perniceni, R. Costi, P. Wind, D. Fuks, B. Gayet

Published in: Techniques in Coloproctology | Issue 3/2018

Abstract

Background

Among the criteria used to diagnose metabolic syndrome (MS), obesity and diabetes mellitus (DM) are associated with poor postoperative outcomes following colectomy. MS is also associated with colorectal cancer (CRC) and diverticulosis, both of which may be treated with colectomy. However, the effect of MS on postoperative outcomes following laparoscopic colectomy has yet to be clarified.

Methods

In an academic tertiary hospital, data from all consecutive patients undergoing laparoscopic colectomy from 2005 to 2014 were prospectively recorded and analysed. Patients presenting with MS [defined by the presence of three or more of the following criteria: elevated blood pressure, body mass index > 28 kg/m², dyslipidemia (decreased serum HDL cholesterol, increased serum triglycerides) and increased fasting glucose/DM] were compared with patients without MS regarding peri-operative outcome [mainly anastomotic leaks, severe postoperative complications (Clavien–Dindo III and IV)] and mortality.

Results

Overall, 1236 patients were included: 508 (41.1%) right colectomies and 728 (58.9%) left colectomies. Seven hundred seventy-two (62.4%) of these procedures were performed for CRC. MS was diagnosed in 85 (6.9%) patients, who were significantly older than the others (70 vs. 64.2 years, p < 0.001), and presented with more cardiac comorbidities (p < 0.001). MS was associated with increased blood loss (122.5 vs. 79.9 mL p = 0.001) and blood transfusion requirement (5.9 vs. 1.7%, p = 0.021). The anastomotic leak rate was 6.6% (with 2.2% of anastomotic leaks requiring surgical treatment), and the overall reoperation rate was 6.9%. The incidence of severe postoperative complications was 11.5%, and the overall mortality rate 0.6%. No differences were found between the groups in overall postoperative morbidity and mortality. Median length of stay was similar in both groups (7 days).

Conclusions

MS does not jeopardize postoperative outcomes following laparoscopic colectomy.

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Title: The effect of metabolic syndrome on postoperative outcomes following laparoscopic colectomy
Authors: A. Zarzavadjian Le Bian
C. Denet
N. Tabchouri
H. Levard
R. Besson
T. Perniceni
R. Costi
P. Wind
D. Fuks
B. Gayet
Publication date: 01-03-2018
Publisher: Springer International Publishing
Published in: Techniques in Coloproctology / Issue 3/2018
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI: https://doi.org/10.1007/s10151-018-1772-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The effect of metabolic syndrome on postoperative outcomes following laparoscopic colectomy

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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