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Abdominal fat ratio - a novel parameter for predicting conversion in laparoscopic colorectal surgery
1Department of Surgery, Northampton General Hospital NHS Trust , Northampton , UK.
Annals of the Royal College of Surgeons of England
|August 10, 2016
Summary
Abdominal fat ratio (AFR) can predict laparoscopic colorectal surgery conversion in obese patients. A higher AFR indicates increased risk, aiding surgeons in identifying challenging cases for better patient outcomes.
Area of Science:
- Colorectal surgery
- Surgical oncology
- Minimally invasive surgery
Background:
- Laparoscopic colorectal cancer resection is standard in the UK.
- Obesity presents technical challenges in laparoscopic surgery.
- Intra-abdominal fat, not just overall obesity, increases surgical difficulty.
Purpose of the Study:
- To introduce and validate the Abdominal Fat Ratio (AFR) as a predictor of conversion to open surgery in obese patients undergoing laparoscopic colorectal cancer resection.
- To assess the correlation between AFR and conversion rates.
Main Methods:
- A retrospective study of 195 patients undergoing elective laparoscopic colorectal cancer resection.
- Preoperative CT scans were used to calculate AFR in obese patients (BMI > 30).
- AFR was assessed by two blinded observers and compared with surgical conversion rates.
Main Results:
- Of 195 patients, 58 were obese.
- Obese patients converted to open surgery had a significantly higher median AFR (5.9) compared to those completed laparoscopically (3.3, P=0.0001).
- No significant difference in conversion rates was found based on BMI, tumor site, or size.
Conclusions:
- Abdominal Fat Ratio (AFR) is a simple, reproducible parameter.
- AFR can help predict the risk of conversion to open surgery in obese patients undergoing laparoscopic colorectal cancer resection.
- AFR adds to the list of risk factors for surgical conversion.
