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World Journal of Surgery

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01-05-2019 | Obesity

Impact of Body Composition on Surgical Outcome in Rectal Cancer Patients, a Retrospective Cohort Study

Authors: C. Heus, N. Bakker, W. M. Verduin, H. J. Doodeman, A. P. J. Houdijk

Published in: World Journal of Surgery | Issue 5/2019

Abstract

Background

Obesity is becoming a bigger health problem every year. Current research shows that the obesity-related metabolic problems are strongly associated with visceral fat and not subcutaneous fat. Visceral obesity (VO) is associated with a worse postoperative outcome in multiple fields of abdominal surgery. On the other hand, muscle mass is related to better postoperative outcome. In rectal cancer patients, we studied the influence of visceral obesity and muscle mass on postoperative complications.

Methods

The visceral fat area (VFA) and skeletal muscle area (SMA) were determined on preoperative CT scans in 406 patients. The preoperative comorbidity, per-operative outcome and postoperative complications were extracted retrospectively from the patient files. VO was defined as a VFA > 100 cm². Correlations between body composition, postoperative complications and LOS were studied.

Results

In our study, 67% of the patients were classified as visceral obese. Mean body mass index (BMI) was higher in the VO group (26.6 ± 3.5 vs 23.5 ± 2.8; p < 0.001). Visceral obese patients had a higher prevalence of cardiac comorbidity (29% vs 13% p = 0.001), hypertension (36% vs 20% p = 0.002) and diabetes mellitus (16% vs 5% p = 0.002). In addition, VO patients had more operative blood loss (431 vs 310 mL; p = 0.008), longer operating time (166 vs 149 min p = 0.003) and more wound infections (14% vs 8% p = 0.048). Visceral obesity was associated with more complications (OR: 1.63 p = 0.043) and longer LOS (risk estimate: 1.18 p = 0.009).

Conclusion

VO patients more often had a history of cardiac disease, hypertension and diabetes mellitus. Visceral obesity correlated with a worse outcome after surgery for rectal cancer.

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Title: Impact of Body Composition on Surgical Outcome in Rectal Cancer Patients, a Retrospective Cohort Study
Authors: C. Heus
N. Bakker
W. M. Verduin
H. J. Doodeman
A. P. J. Houdijk
Publication date: 01-05-2019
Publisher: Springer International Publishing
Keywords: Obesity
Wound Infection
Rectal Cancer
Obesity
Rectal Cancer
Published in: World Journal of Surgery / Issue 5/2019
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-019-04925-z

At a glance: The STEP trials

Springer Medicine

Impact of Body Composition on Surgical Outcome in Rectal Cancer Patients, a Retrospective Cohort Study

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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