title: Measurement of visceral fat on preoperative computed tomography predicts complications after sigmoid colectomy for diverticular disease.
abstract: BACKGROUND
  Visceral and subcutaneous abdominal fat parameters have been associated with worse surgical outcomes in colorectal cancer but have not been investigated in diverticulitis.
  
  
  METHODS
  Volumetric fat parameters were measured on preoperative computed tomography scans from 211 diverticulitis patients. Primary outcome was a serious postoperative complication (Clavien-Dindo grades 2-4). Variables including age, disease duration, American Society of Anesthesiology score, ostomy, immunosuppression, body mass index, and volumetric fat parameters were examined. SPSS was used for statistics.
  
  
  RESULTS
  The serious postoperative complication rate was 12.7%. On univariate analysis, several factors including older age (P = .0001), ostomy creation (P = .02), higher visceral fat (VF, P = .01), emergent surgery (P = .05), and higher American Society of Anesthesiology score (P = .05) were associated with complications. On multivariate regression analysis, only VF was independently associated with complications.
  
  
  CONCLUSIONS
  Diverticulitis patients with high VF are more likely to develop complications after sigmoidectomy. VF measurement may potentially be used as a tool to assist in surgical decision making and prediction of outcomes.
authors.affiliation: Department of radiology, Wake Forest School of Medicine, One Medical Center Boulevard, Winston-Salem, NC 27157, USA.
authors.forename: Rafel
authors.initials: R
authors.lastname: Tappouni
authors.affiliation: Department of Surgery, Division of Colon & Rectal Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Mathew
authors.affiliation: Department of Surgery, Division of Colon & Rectal Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033, USA.
authors.forename: Tara M
authors.initials: TM
authors.lastname: Connelly
authors.affiliation: Department of radiology, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033, USA.
authors.forename: Franklyn
authors.initials: F
authors.lastname: Luke
authors.affiliation: Department of Surgery, Division of Colon & Rectal Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033, USA. Electronic address: emessaris@hmc.psu.edu.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Messaris
mesh_terms: D003082:Colectomy; D004238:Diverticulitis / Q000601:surgery*; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011183:Postoperative Complications / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012189:Retrospective Studies; D012810:Sigmoid Diseases / Q000601:surgery*; D014057:Tomography, X-Ray Computed
keywords: Complications; Diverticulitis; Sigmoidectomy; Visceral fat; Volumetric fat parameters