Association between Higher Body Mass Index and Pouch-Related Complications during Restorative Proctocolectomy in Patients with Ulcerative Colitis

Abstract

Background/Aims: Higher body mass index (BMI) is associated with an increased risk of postoperative complications, but only a few studies have clarified the effect of higher BMI on perioperative outcomes in ulcerative colitis (UC). The ­purpose of this study was to evaluate the effect of higher BMI on patients undergoing surgery for UC. Methods: UC patients who underwent surgery between April 2012 and August 2015 were included. Higher BMI was defined as a BMI ≥25 kg/m². Patients were classified as having a higher BMI or an unelevated BMI. We analyzed comparison characteristics, surgical outcomes, and pouch-related complications (PRC). Possible risk factors for PRC were also analyzed. Results: A total of 16 out of 165 (9.7%) patients had higher BMIs. The incidence of PRC in patients with higher BMIs was significantly higher than in those with unelevated BMIs. Male gender (OR 3.86, 95% CI 1.23–15.4, p = 0.02) and BMI ≥25 kg/m² (OR 5.87, 95% CI 1.59–21.67, p < 0.01) were identified as independent risk factors for PRC. Conclusion: UC patients with higher BMIs had significantly higher incidences of PRC. Male gender and a higher BMI were identified as independent risk factors for PRC. The pouch operation as an initial surgery may be avoided in patients with higher BMIs to prevent PRC.

Impact of the body mass index on the retention of the anorectal mucosa after double-stapled ileal pouch-anal anastomosis for ulcerative colitis

“…The suture device does not go deep enough, and the site of stapling and division is far away from the dentate line, resulting in an increase in retained mucosa. Difficulties in deep pelvic manipulation led to various postoperative complications in surgery for UC [ 11 – 13 ]. Increased blood loss and a prolonged operative time are observed in patients with high BMI values [ 2 , 13 ].…”

Systematic review and meta-analysis: association between obesity/overweight and surgical complications in IBD

“…After preliminary screening and review, 2371 studies were excluded due to their inconsistency with the research topic, or the articles were review studies, or the type of surgery was inconsistent (such as weight loss surgery). Moreover, after carefully reading, reviewing, and confirming the full-text content, a total of 15 studies were finally included [10,[13][14][15][16][18][19][20][21][22][23][24][25][26][27] to form this meta-analysis. The detailed inclusion and exclusion process of the articles has been shown in Fig.…”

“…One of these 15 observational studies [14] used the propensity score-matched analysis to analyze the data. Besides, one was jointly completed by researchers from three countries: The Netherlands, Belgium, and the USA, two were from Japan [21,25], and the remaining 12 were reported from the USA [10, 13-16, 18, 20, 22-24, 26, 27]. In this meta-analysis, the patients in one article were children only [26], and the rest were all adults.…”

“…In this meta-analysis, the patients in one article were children only [26], and the rest were all adults. In addition, there were four studies with only CD patients [13,18,20,27], and five studies with only UC patients [14,21,22,24,25]. All patients underwent different types of surgery.…”

The advanced lung cancer inflammation index predicts outcomes in patients with Crohn’s disease after surgical resection

“…Preoperative ALI predicts surgical relapse in CD patients with higher accuracy compared with other nutrition-related factors in combination At first, we focused on representative nutrition-based markers based on previous evidence in the literature for nutrition-based prognostic biomarkers in several malignancies and IBD [11,21,23,[26][27][28]. We compared all of these factors in preoperative status for predictive potential of surgical relapse in CD patients (Fig.…”