Related Experiment Video
Updated: Jan 24, 2026
Surgical Approach and Complications of Stand-alone Lateral Trans-Psoas Interbody Fusion
Published on: February 14, 2025
The impact of abnormal BMI on surgical complications after pediatric colorectal surgery
Angela M Kao1, Michael R Arnold1, Tanushree Prasad2
1Department of Surgery, Carolinas Medical Center, 1000 Blythe Blvd, MEB Suite 601, Charlotte, NC 28203.
Insights
Childhood obesity increases surgical risks. Higher body mass index (BMI) in pediatric patients undergoing colorectal surgery correlates with greater wound complications and longer hospital stays.
Area of Science:
- Pediatric Surgery
- Obesity Research
- Gastroenterology
Background:
- Childhood obesity is a significant public health concern.
- The impact of body mass index (BMI) on pediatric surgical outcomes is not well-understood.
- Elective colorectal procedures in children present unique challenges related to nutritional status.
Purpose of the Study:
- To evaluate the association between BMI and surgical outcomes in children undergoing elective colorectal surgery.
- To identify specific complications linked to varying weight classifications in pediatric patients.
- To provide data for optimizing surgical care for obese and overweight children.
Main Methods:
- Analysis of data from the NSQIP-Pediatric database for children aged 2-18 years.
- Classification of patients into underweight, normal weight, overweight, and obese categories based on BMI.
- Comparison of postoperative complication rates, including surgical site infections (SSI), between weight cohorts.
Main Results:
- Obese and overweight children experienced higher rates of deep incisional SSI and superficial wound disruption compared to normal weight peers.
- An incremental increase in BMI was associated with a higher likelihood of developing deep incisional SSI and superficial wound disruption.
- Increased incidence of septic shock, urinary tract infections (UTI), longer operative times, mechanical ventilation, and hospital length of stay (LOS) were observed in higher BMI groups.
Conclusions:
- Elevated BMI is linked to increased wound complications in pediatric patients undergoing elective intestinal surgery for inflammatory bowel disease (IBD).
- Preoperative optimization and weight management strategies may be crucial for reducing SSI and infectious complications.
- Further research into weight-specific interventions can improve surgical outcomes for children.
Background/Purpose:
While childhood obesity is a growing problem, the implications of BMI on elective pediatric surgery remains poorly described. This study evaluates the impact of obesity on surgical outcomes after elective colorectal procedures.
Methods:
Children ages 2-18 years undergoing elective colorectal surgery for IBD were identified from the NSQIP-Pediatric database. Patients were classified as underweight (UW), normal weight (NW), overweight (OW) and obese (OB) based on their age- and sex-adjusted BMI. Postoperative complications were compared between cohorts.
Results:
858 patients (14.8% UW, 64.3% NW, 13.1% OW, 7.8% OB) were identified, with overall complications occurring in 15.3% and SSI in 10.1%. Obese/overweight patients had higher rates of deep incisional SSI (4.5%OB, 4.5%OW, 0%NW, p=0.002) and superficial wound disruption (5.4%OB, 5.8%OW, 1.6%NW, p=0.04). Incremental increase in BMI by 1.0kg/m2 was associated with 4.3% increased likelihood of developing deep incisional SSI and 2.3% increase of superficial wound disruption. Obese/overweight children also had increased incidence of septic shock and UTI, as well as longer operative times, days of mechanical ventilation and LOS.
Conclusions:
Increasing BMI was associated with increased wound complications in IBD patients undergoing elective intestinal surgery. Preoperative optimization and weight loss strategies may potentially reduce SSI and other infectious complications.
Level Of Evidence:
III.
Related Concept Videos
02:23Abnormal Proliferation
01:19Impact of Groups on Groups
01:24Hemodialysis II: Procedure and Complications
01:15Diabetes: Symptoms, Diagnosis, and Complications
01:30Pneumonia III: Complications and Assessment
01:30Respiratory System Abnormal Finding I: Inspection and Percussion
Inspection Findings
During an inspection, several findings may suggest the presence of respiratory distress or disease. Pursed-lip breathing, where exhalation is slowed by...