Simple measurement of intra-abdominal fat for abdominal surgery outcome prediction. Academic Article uri icon

Overview

abstract

  • OBJECTIVE: To assess the effect of increasing body mass index, intra-abdominal fat, and outer abdominal fat on outcome in patients undergoing major hepatectomy. DESIGN: Cohort study. SETTING: Memorial Sloan-Kettering Cancer Center. PARTICIPANTS: We studied patients aged 19 to 86 years undergoing major hepatic resection between June 18, 1996, and November 6, 2001. Complications were extracted from a prospective database at a tertiary cancer center. INTERVENTION: A total of 349 patients were grouped according to body mass index for analysis. Preoperative abdominal computed tomographic scans were examined and measurements of perinephric fat (as a surrogate for intra-abdominal fat) and outer abdominal fat taken at uniform anatomical locations. MAIN OUTCOME MEASURES: We compared 30-day mortality and morbidity figures, length of stay, and operating times. RESULTS: Body mass index had an influence on operative time (P = .02) but no significant effect on mortality, frequency of any complications, frequency of severe complications, or length of stay (P = .80, P = .89, P = .16, and P = .81, respectively). Outer abdominal fat had no significant effect on any of the 5 outcome measures. Perinephric fat measurements had a significant effect on most outcome measures (P = .004 for mortality, P = .003 for frequence of complications, P < .001 for frequence of severe complications, and P = .001 for length of stay). CONCLUSIONS: Outer appearances of obesity do not correlate with poor outcomes for major upper abdominal operations. A simple measurement of perinephric fat, as a surrogate for intra-abdominal fat, on preoperative imaging gives a more useful risk assessment for patients undergoing major upper abdominal operations.

publication date

  • November 1, 2010

Research

keywords

  • Hepatectomy
  • Intra-Abdominal Fat

Identity

Scopus Document Identifier

  • 78449242908

Digital Object Identifier (DOI)

  • 10.1001/archsurg.2010.222

PubMed ID

  • 21079095

Additional Document Info

volume

  • 145

issue

  • 11