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Perirenal fat surface area as a risk factor for perioperative difficulties and 30‐day postoperative complications in elective colon cancer surgery
Author(s) -
Hagopian O.,
Dahlberg M.,
Heinius G.,
Nordberg J.,
Gustafsson J.,
Nordenvall C.,
Sandblom G.,
Farahnak P.,
Everhov Å. H.
Publication year - 2018
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.14322
Subject(s) - medicine , perioperative , surgery , complication , colorectal cancer , cancer
Aim Visceral obesity is associated with perioperative and postoperative complications in colorectal surgery. We aimed to investigate the association between the perirenal fat surface area ( PRF ) and postoperative complications. Method Data on 610 patients undergoing curative, elective colon cancer resection between 2006 and 2016 at Stockholm South General Hospital were retrieved from a local quality register. We assessed perioperative and postoperative outcomes using a multinomial regression model adjusted for age, sex, American Society of Anesthesiologists classification and surgical approach (open/laparoscopy) in relation to PRF . Results PRF could be measured in 605 patients; the median area was 24 cm 2 . Patients with PRF ≥ 40 cm 2 had longer operation time (median 223 vs 184 min), more intra‐operative bleeding (250 vs 125 ml), reoperations (11% vs 6%), surgical complications (27% vs 13%) and nonsurgical infectious complications (16% vs 9%) than patients with PRF < 40 cm 2 , but there were no differences in the need for intensive care or duration of hospital stay. The multivariate analyses revealed an increased risk of any complication [ OR 1.68 (95% CI 1.1–2.6)], which was even more pronounced for moderate complications [Clavien–Dindo II , OR 2.14 ( CI 1.2–2.4]; Clavien–Dindo III , OR 2.35 ( CI 1.0–5.5)] in patients with PRF ≥ 40 vs < 40 cm 2 . The absolute risk of complications was similar in men and women with PRF ≥ 40 cm 2 . Conclusion PRF , an easily measured indirect marker of visceral obesity, was associated with overall and moderate complications in men and women and could serve as a useful tool in the assessment of preoperative risk.