TY - JOUR
T1 - Visceral obesity is a preoperative risk factor for postoperative ileus after surgery for colorectal cancer
T2 - Single-institution retrospective analysis
AU - Morimoto, Yoshihiro
AU - Takahashi, Hidekazu
AU - Fujii, Makoto
AU - Miyoshi, Norikatsu
AU - Uemura, Mamoru
AU - Matsuda, Chu
AU - Yamamoto, Hirofumi
AU - Mizushima, Tsunekazu
AU - Mori, Masaki
AU - Doki, Yuichiro
N1 - Funding Information:
Author T.M. was supported by donations from Kinshukai Medical Corporation.
Publisher Copyright:
© 2019 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterology
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Aim: Visceral obesity (VO) reportedly has a stronger association with complications after colorectal surgery than does body mass index. Here, we retrospectively assessed VO as a risk factor for postoperative ileus (POI) after colorectal resection in patients with colorectal cancer. Methods: This study included 417 consecutive patients with colorectal cancer who underwent elective surgery at our institute from January 2010 to December 2012. Visceral fat area (VFA) was calculated by image analysis software. VO was defined as VFA ≥100 cm2. We assessed 49 factors, including VO, comorbidities, surgical procedure, and postoperative complications. Data were analyzed using a propensity score-matching strategy. Results: Postoperative ileus occurred in 18 patients (4.3%) from the entire cohort, and in 14 (5.5%) of the 256 matched patients. Multivariate analysis (n = 417 patients) showed that significant risk factors for POI included VO (OR 7.9, 95% confidence interval [CI] 1.9-32.1, P =.004), open surgery (OR 6.4, 95% CI 1.6-26.7, P =.010), and pelvic/intra-abdominal abscess (OR 11.0, 95% CI 1.1-110.2, P =.041). Propensity score matching showed two independent risk factors in the multivariate analysis: VO (OR 6.2, 95% CI 1.3-30.4, P =.025) and open surgery (OR 9.1, 95% CI 2.0-40.5, P =.004). Conclusion: Visceral obesity may be an independent risk factor for POI in patients with colorectal cancer.
AB - Aim: Visceral obesity (VO) reportedly has a stronger association with complications after colorectal surgery than does body mass index. Here, we retrospectively assessed VO as a risk factor for postoperative ileus (POI) after colorectal resection in patients with colorectal cancer. Methods: This study included 417 consecutive patients with colorectal cancer who underwent elective surgery at our institute from January 2010 to December 2012. Visceral fat area (VFA) was calculated by image analysis software. VO was defined as VFA ≥100 cm2. We assessed 49 factors, including VO, comorbidities, surgical procedure, and postoperative complications. Data were analyzed using a propensity score-matching strategy. Results: Postoperative ileus occurred in 18 patients (4.3%) from the entire cohort, and in 14 (5.5%) of the 256 matched patients. Multivariate analysis (n = 417 patients) showed that significant risk factors for POI included VO (OR 7.9, 95% confidence interval [CI] 1.9-32.1, P =.004), open surgery (OR 6.4, 95% CI 1.6-26.7, P =.010), and pelvic/intra-abdominal abscess (OR 11.0, 95% CI 1.1-110.2, P =.041). Propensity score matching showed two independent risk factors in the multivariate analysis: VO (OR 6.2, 95% CI 1.3-30.4, P =.025) and open surgery (OR 9.1, 95% CI 2.0-40.5, P =.004). Conclusion: Visceral obesity may be an independent risk factor for POI in patients with colorectal cancer.
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U2 - 10.1002/ags3.12291
DO - 10.1002/ags3.12291
M3 - Article
AN - SCOPUS:85083540016
VL - 3
SP - 657
EP - 666
JO - Annals of Gastroenterological Surgery
JF - Annals of Gastroenterological Surgery
SN - 2475-0328
IS - 6
ER -