title: Impact of visceral obesity on outcomes of laparoscopic colorectal surgery: a meta-analysis.
abstract: BACKGROUND
  Excessive visceral fat could influence surgical difficulty of laparoscopic colorectal surgery. With the use of visceral fat area measured by computed tomography, surgeons could quantify the amount of visceral fat. The aim of the present meta-analysis is to quantitatively combine studies in order to determine the impact of visceral obesity on laparoscopic colorectal surgery.
  
  
  METHODS
  A systematic search of literature (PubMed, EMBASE, the Cochrane Library) was performed to identify studies evaluating the impact of visceral obesity on laparoscopic colorectal surgery.
  
  
  RESULTS
  Four studies were included in this meta-analysis. Meta-analysis revealed that visceral obesity was associated with longer operative time (weighted mean difference (WMD) 24.42, 95% confidence interval (CI) 12.98-35.86), less lymph nodes harvest (WMD -5.99, 95% CI -8.31 to -3.67), more conversion to open procedure (odds ratio (OR) 2.24, 95% CI 1.05-4.78), higher morbidity (OR 2.33, 95% CI 1.56-3.48), more surgical site infection (OR 3.22, 95% CI 1.95-5.32) and more anastomotic leakage (OR 2.40, 95% CI 1.06-5.44).
  
  
  CONCLUSIONS
  The present study shows that visceral obesity is associated with increased surgical difficulty and post-operative morbidity of laparoscopic colorectal surgery but does not affect post-operative recovery thanks to laparoscopic procedure.
authors.affiliation: Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Tinghan
authors.initials: T
authors.lastname: Yang
authors.affiliation: Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Mingtian
authors.initials: M
authors.lastname: Wei
authors.affiliation: Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Yazhou
authors.initials: Y
authors.lastname: He
authors.affiliation: Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Xiangbing
authors.initials: X
authors.lastname: Deng
authors.affiliation: Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Ziqiang
authors.initials: Z
authors.lastname: Wang
mesh_terms: D057868:Anastomotic Leak; D003107:Colorectal Surgery; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D056128:Obesity, Abdominal / Q000150:complications* / Q000000981:diagnostic imaging; D061646:Operative Time; D011183:Postoperative Complications; D012307:Risk Factors; D013530:Surgical Wound Infection; D014057:Tomography, X-Ray Computed
keywords: colorectal surgery; laparoscopic surgery; meta-analysis; visceral fat area; visceral obesity