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Visceral obesity determined by CT scan and outcomes after colorectal surgery; a systematic review and meta-analysis
Hamit Cakir1, Colin Heus, Tjeerd J van der Ploeg
1Department of Surgery, Medical Centre Alkmaar, PO 1815 JD, Alkmaar, The Netherlands, cakir_hamit@hotmail.com.
Background:
Visceral obesity may affect outcome after colorectal surgery. The visceral fat area as determined by CT scanning is considered the standard in the detection of visceral obesity.
Method:
A systematic review was performed of trials investigating the effect of visceral obesity on outcomes of patients with colorectal cancer with no radiotherapy or chemotherapy and measured by CT scanning. The main endpoints were primary hospital stay, morbidity, operative time and blood loss. Quality assessment and data extraction were performed independently by two observers.
Results:
Seven studies were eligible for analysis, including 1230 patients. Primary hospital stay (weighted mean difference 1.16 days, 95% CI 0.0.05 to 2.28 days, p = 0.04), morbidity rates (RR 0.15, 95% CI 0.10 to 0.21, p < 0.00001) and operative time (weighted mean difference 20.47 min, 95% CI 12.76 to 28.17 min, p < 0.00001) were significantly higher for visceral obese patients. No difference was found in blood loss.
Conclusion:
Visceral obesity leads to a longer hospital stay, higher morbidity and longer operative time after elective colon surgery. These findings show that the preoperative CT scan for detecting disseminated disease can be used to assess visceral obesity and helps in risk profiling patients undergoing elective colon surgery.
