Visceral obesity is a preoperative risk factor for postoperative ileus after surgery for colorectal cancer: Single-institution retrospective analysis

Abstract

Aim: Visceral obesity (VO) reportedly has a stronger association with complications after colorectal surgery than does body mass index. Here, we retrospectively assessed VO as a risk factor for postoperative ileus (POI) after colorectal resection in patients with colorectal cancer. Methods: This study included 417 consecutive patients with colorectal cancer who underwent elective surgery at our institute from January 2010 to December 2012. Visceral fat area (VFA) was calculated by image analysis software. VO was defined as VFA ≥100 cm2. We assessed 49 factors, including VO, comorbidities, surgical procedure, and postoperative complications. Data were analyzed using a propensity score-matching strategy. Results: Postoperative ileus occurred in 18 patients (4.3%) from the entire cohort, and in 14 (5.5%) of the 256 matched patients. Multivariate analysis (n = 417 patients) showed that significant risk factors for POI included VO (OR 7.9, 95% confidence interval [CI] 1.9-32.1, P =.004), open surgery (OR 6.4, 95% CI 1.6-26.7, P =.010), and pelvic/intra-abdominal abscess (OR 11.0, 95% CI 1.1-110.2, P =.041). Propensity score matching showed two independent risk factors in the multivariate analysis: VO (OR 6.2, 95% CI 1.3-30.4, P =.025) and open surgery (OR 9.1, 95% CI 2.0-40.5, P =.004). Conclusion: Visceral obesity may be an independent risk factor for POI in patients with colorectal cancer.