title: The impact of visceral obesity on surgical outcomes of laparoscopic surgery for colon cancer.
abstract: OBJECTIVE
  Although obesity is considered as a risk factor for postoperative morbidity in abdominal surgery, its effect on the outcomes of laparoscopic-assisted colectomy (LAC) is still unclear. The technical difficulty and risk factor for postoperative complication in LAC are thought to be influenced by visceral obesity. The aim of this prospective study was to evaluate the impact of visceral fat on the surgical outcomes of LAC.
  
  
  METHODS
  Between April 2005 and December 2010, consecutive patients with preoperatively diagnosed colon cancer, excluding medium and low rectal cancer, who underwent LAC, were enrolled. Their visceral fat area (VFA) and body mass index (BMI) were prospectively collected. The VFA was assessed by Fat Scan software. The patients were classified into two groups as follows: VFA nonobese with VFA <100 cm(2) (VNO) and VFA obese with VFA ≧100 cm(2) (VO). The predictive factors for surgical complications of LAC were evaluated by univariate and logistic regression analyses.
  
  
  RESULTS
  A total of 338 consecutive patients were enrolled in this study. Of the 338 patients, 194 (57.4 %) and 138 (42.6 %) were classified into the VNO and VO groups, respectively. Logistic regression analysis showed that high BMI (≧25 kg/m(2)) and VO independently predicted the incidence of overall postoperative complications (p = 0.040 and 0.007, respectively). VO was more highly related to the incidence of overall postoperative complications, anastomotic leakage (p = 0.021), and surgical site infection (SSI) (p = 0.013) than high BMI.
  
  
  CONCLUSIONS
  VFA is a more useful parameter than BMI in predicting surgical outcomes after LAC.
authors.affiliation: Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan, nabe-jun@comet.ocn.ne.jp.
authors.forename: Jun
authors.initials: J
authors.lastname: Watanabe
authors.forename: Kenji
authors.initials: K
authors.lastname: Tatsumi
authors.forename: Mitsuyoshi
authors.initials: M
authors.lastname: Ota
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Suwa
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Suzuki
authors.forename: Akira
authors.initials: A
authors.lastname: Watanabe
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ishibe
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Watanabe
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Akiyama
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ichikawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Morita
authors.forename: Itaru
authors.initials: I
authors.lastname: Endo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications* / Q000000981:diagnostic imaging; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D011859:Radiography; D012307:Risk Factors; D016896:Treatment Outcome