title: Computed tomography volumetric fat parameters versus body mass index for predicting short-term outcomes of colon surgery.
abstract: BACKGROUND
  At present, the impact of obesity on short-term outcomes of general surgery remains controversial, especially in the field of laparoscopy. Most studies on the subject have used the body mass index (BMI) to define obesity without distinguishing between visceral and subcutaneous storage. Computed tomography (CT) volumetric analysis permits accurate evaluation of site-specific volume of adipose tissue. The purpose of this study was to compare CT volumetric fat parameters and the BMI for predicting short-term outcomes of colon surgery.
  
  
  METHODS
  A retrospective analysis was conducted of 231 consecutive patients undergoing elective colon resection, with open or laparoscopic technique, from January 2007 to April 2009. CT volumetric quantification of abdominal visceral and subcutaneous adipose tissue was performed. Intraoperative and perioperative data were collected.
  
  
  RESULTS
  A total of 187 patients were enrolled. BMI showed a direct correlation with fat volumetric parameters but not with the visceral/subcutaneous fat ratio. Operating time was correlated with subcutaneous fat storage and BMI in the laparoscopic right colectomy subgroup. No associations were found with the conversion rate. Length of the hospital stay was correlated with the visceral/subcutaneous fat ratio in the laparoscopic left colectomy subgroup. Whereas the overall postoperative complication rate and mortality were not associated with fat parameters, the postoperative surgical complication rate was associated with visceral volumetric parameters in the laparoscopic left colectomy subgroup.
  
  
  CONCLUSIONS
  Short-term outcomes of colon surgery are better predicted by fat volumetric parameters than by the BMI. This study has provided new elements for discussion on the impact of visceral and subcutaneous adiposity in laparoscopic and traditional colon surgery.
authors.affiliation: Section of General Surgery, Department of Surgical Sciences, Parma City Hospital, Parma University-Medical School, 14 Gramsci Street, Parma, 43100, Italy. ste.cecchini79@libero.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Cecchini
authors.forename: Egildo
authors.initials: E
authors.lastname: Cavazzini
authors.forename: Federico
authors.initials: F
authors.lastname: Marchesi
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Sarli
authors.forename: Luigi
authors.initials: L
authors.lastname: Roncoroni
mesh_terms: D050153:Abdominal Fat / Q000000981:diagnostic imaging* / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003082:Colectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome