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High visceral to subcutaneous fat area ratio predicts early postoperative small bowel obstruction after surgery for colorectal cancer

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Abstract

Purpose

Risks for postoperative small bowel obstruction have been demonstrated in several reports, most of which indicated male sex was a risk factor, but with the reason remaining unknown. We tested the hypothesis that it could be because males have more visceral fat than females. This prospective observational study aims to examine risks of early postoperative small bowel obstruction (EPSBO) after colorectal cancer surgery and the association between visceral to subcutaneous fat area ratio (V/S ratio) and EPSBO.

Methods

Four hundred and seventy-four patients who underwent colectomy for colorectal cancer in our hospital were enrolled in this study. The influence of several factors including V/S ratio on the development of EPSBO was analyzed.

Results

Thirty-one of the 474 patients (6.5%) developed EPSBO. EPSBO occurred more frequently in males (p = 0.03) and cases who developed postoperative anastomotic leakage (p < 0.001) or wound infection (p = 0.02). Higher V/S ratio was strongly related to male sex (p < 0.001). Multivariate analysis revealed higher V/S ratio (OR 2.25; p = 0.049) and anastomotic leakage (OR 5.86; p < 0.001) were independent risk factors for EPSBO.

Conclusion

Higher V/S ratio was significantly related to EPSBO, suggesting that one of the reasons EPSBO was more likely to occur in males because they have more visceral fat than females. Preoperative identification of this risk factor could help us watch out for this potential complication.

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Data availability

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

EPSBO :

Early postoperative small bowel obstruction

V/S ratio :

Visceral to subcutaneous fat area ratio

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Acknowledgements

The authors thank Benjamin Phillis of the Clinical Study Support Center at Wakayama Medical University for proofreading and editing this article.

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Authors and Affiliations

  1. Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510, Japan

    Yuki Nakamura, Kenji Matsuda, Shozo Yokoyama, Hiromitsu Iwamoto, Yuki Mizumoto, Yasuyuki Mitani, Yoshimasa Oku & Hiroki Yamaue

Authors
  1. Yuki Nakamura
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  2. Kenji Matsuda
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  3. Shozo Yokoyama
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  4. Hiromitsu Iwamoto
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  5. Yuki Mizumoto
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  6. Yasuyuki Mitani
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  7. Yoshimasa Oku
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  8. Hiroki Yamaue
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Contributions

YN, KM, YO, and HY developed the study concept and design of the study. All authors participated in data acquisition. YN and KM performed the analysis of the data. YN wrote this manuscript under the supervision of KM and HY. All authors reviewed and approved the final manuscript.

Corresponding author

Correspondence to Kenji Matsuda.

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Ethics approval

Approval was obtained from the ethics committee of Wakayama Medical University. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare no competing interests.

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Nakamura, Y., Matsuda, K., Yokoyama, S. et al. High visceral to subcutaneous fat area ratio predicts early postoperative small bowel obstruction after surgery for colorectal cancer. Langenbecks Arch Surg 407, 2021–2026 (2022). https://doi.org/10.1007/s00423-022-02518-4

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  • DOI: https://doi.org/10.1007/s00423-022-02518-4

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