Measurement of visceral fat on preoperative computed tomography predicts complications after sigmoid colectomy for diverticular disease

Tappouni, Rafel; Mathew, Paul; Connelly, Tara M.; Luke, Franklyn E.; Messaris, Evangelos

doi:10.1016/j.amjsurg.2014.10.026

Cited by 11 publications

(7 citation statements)

References 25 publications

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“…Visceral obesity, as revealed by an increased VFA or VFA vs the SFA ratio (MFI), has been demonstrated to be a prognostic marker of complications after colorectal surgery, gastrectomy, and nephrectomy 38 . ‐ 41 Tappouni et al 42 showed that a higher amount of visceral fat (but not the MFI) can predict complications after sigmoid colectomy for diverticular disease. In CD, however, increased mesenteric fat reflects not only visceral obesity but also mesenteric inflammation.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Sarcopenia and Its Impact on Postoperative Outcome in Patients With Crohn's Disease Undergoing Bowel Resection

Zhang

Cao

et al. 2015

J Parenter Enteral Nutr

107

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Section: Discussionmentioning

confidence: 99%

Prevalence of Sarcopenia and Its Impact on Postoperative Outcome in Patients With Crohn's Disease Undergoing Bowel Resection

Zhang

Cao

et al. 2015

J Parenter Enteral Nutr

107

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“…Our findings that an increased VAT area is associated with an extended LOS are consistent with previous studies on different disease types in several patient populations. 15 , 16 , 18 , 23 , 24 Two recent studies of 139 and 110 patients have shown that an increased VAT area was associated with increased postoperative complications in patients who underwent surgery for gastric or colorectal cancer. 18 , 24 Although our study did not show a relationship between VAT area and postoperative complications, both increased LOS and complications are adverse outcomes that likely result from poor overall health.…”

Section: Discussionmentioning

confidence: 99%

“… 16 In addition, patients undergoing surgery for diverticular disease showed an association between increased VAT area and increased postoperative complications. 15 It has been proposed that the adverse effects of visceral adiposity on outcome may be due to its effect on cardiometabolic risk, including higher incidence of hypertension, diabetes, and the metabolic syndrome. 25 , 26 In patients with colorectal cancer, VAT is superior to BMI in predicting the presence of cardiometabolic comorbidities.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have shown some of these CT body composition measurements to be associated with increased length of hospital stay (LOS), readmission, postoperative complications, and other adverse outcomes in patients with various gastrointestinal malignancies. 15 16 17 18 However, the association of these measurements with adverse postoperative events in patients with long bone metastases undergoing surgery remains unexplored.…”

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confidence: 99%

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Body Composition Predictors of Adverse Postoperative Events in Patients Undergoing Surgery for Long Bone Metastases

et al. 2022

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Introduction: Body composition assessed using opportunistic CT has been recently identified as a predictor of outcome in patients with cancer. The purpose of this study was to determine whether the crosssectional area (CSA) and the attenuation of abdominal subcutaneous adipose tissue, visceral adipose tissue (VAT), and paraspinous and abdominal muscles are the predictors of length of hospital stay, 30-day postoperative complications, and revision surgery in patients treated for long bone metastases.Methods: A retrospective database of patients who underwent surgery for long bone metastases from 1999 to 2017 was used to identify 212 patients who underwent preoperative abdominal CT. CSA and attenuation measurements for subcutaneous adipose tissue, VAT, and muscles were taken at the level of L4 with the aid of an in-house segmentation algorithm. Bivariate and multivariate linear and logistic regression models were created to determine associations between body composition measurements and outcomes while controlling for confounders, including primary tumor, metastasis location, and preoperative albumin.Results: On multivariate analysis, increased VAT CSA {regression coefficient (r) (95% confidence interval [CI]); 0.01 (0.01 to 0.02); P , 0.01} and decreased muscle attenuation (r [95% CI] 20.07 [20.14 to 20.01]; P = 0.04) were associated with an increased length of hospital stay. In bivariate analysis, increased muscle CSA was associated with increased chance of revision surgery (odds ratio [95% CI]; 1.02 [1.01 to 1.03]; P = 0.04). No body composition measurements were associated with postoperative complications within 30 days.Discussion: Body composition measurements assessed using opportunistic CT predict adverse postoperative outcomes in patients operated for long bone metastases.

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“…On univariate analysis, several factors including older age ( p = 0.0001), ostomy creation ( p = 0.02), higher VF ( p = 0.01), emergent surgery ( p = 0.05), and higher American Society of Anesthesiology score ( p = 0.05) were associated with complications. On multivariate regression analysis, the only factor independently associated with complications was higher VF [55].…”

Section: Obesity As Risk Factor For Worse Outcome After Surgerymentioning

confidence: 99%

Excessive Body Weight and Diverticular Disease

Böhm¹

2021

Visc Med

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Background: The worldwide proportion of overweight adults almost doubled from 22% in 1975 to 39% in 2016. Comparably, for the USA and Germany in 2016, the proportion was 68 and 56.8%, respectively. In Olmsted County, Minnesota, the prevalence of diverticulitis also doubled between 1980 and 2007, from 19 to 40%. Obesity substantially increases the risk of multiple gastrointestinal (GI) diseases and non-GI diseases. In a narrative review, we examined the evidence on whether obesity also increases the risk for the development of diverticulosis or diverticular disease and its outcome. Summary: Evidence suggests that being overweight (body mass index ≥25 kg/m2) or obese (≥30 kg/m2), especially viscerally obese, is a risk factor for diverticulosis, diverticular disease and diverticulitis, diverticular bleeding, more severe or complicated disease, recurrent disease, and for worse outcomes after surgery. Key Messages: There is a well-founded association between overweight and diverticular disease as well as diverticulosis. It is not clear whether overweight per se or confounders linked with it are responsible for the association. However, means to fight the overweight and obesity epidemic might also help to reduce the prevalence of morbidity and mortality from diverticular disease.

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Measurement of visceral fat on preoperative computed tomography predicts complications after sigmoid colectomy for diverticular disease

Cited by 11 publications

References 25 publications

Prevalence of Sarcopenia and Its Impact on Postoperative Outcome in Patients With Crohn's Disease Undergoing Bowel Resection

Prevalence of Sarcopenia and Its Impact on Postoperative Outcome in Patients With Crohn's Disease Undergoing Bowel Resection

Body Composition Predictors of Adverse Postoperative Events in Patients Undergoing Surgery for Long Bone Metastases

Excessive Body Weight and Diverticular Disease

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