Impact of Visceral Obesity on Short-term Outcome After Laparoscopic Surgery for Colorectal Cancer

Nitori, Nobuhiro; Hasegawa, Hirotoshi; Ishii, Yoshiyuki; Endo, Takashi; Kitagawa, Yuko

doi:10.1097/sle.0b013e3181ae5442

Cited by 43 publications

(64 citation statements)

References 22 publications

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“…A number of studies including a meta-analysis support the notion that abdominal and/or visceral obesity specifically increases the risk for colorectal cancer independent of total adiposity (245,299,573,630). Increased visceral adipose tissue accumulation also seems to predict poorer response to chemotherapy treatment and increased complication rates as a result of surgery (200,400). Whether rates of adenomatous polyps, the precursor of colorectal cancer, are related to abdominal obesity is uncertain (259,489).…”

Section: E Cancersmentioning

confidence: 88%

Pathophysiology of Human Visceral Obesity: An Update

Tchernof

Després

2013

Physiological Reviews

1,985

1,613

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LTchernof A, Després J-P. Pathophysiology of Human Visceral Obesity: An Update. Physiol Rev 93: 359 -404, 2013; doi:10.1152/physrev.00033.2011.-Excess intra-abdominal adipose tissue accumulation, often termed visceral obesity, is part of a phenotype including dysfunctional subcutaneous adipose tissue expansion and ectopic triglyceride storage closely related to clustering cardiometabolic risk factors. Hypertriglyceridemia; increased free fatty acid availability; adipose tissue release of proinflammatory cytokines; liver insulin resistance and inflammation; increased liver VLDL synthesis and secretion; reduced clearance of triglyceride-rich lipoproteins; presence of small, dense LDL particles; and reduced HDL cholesterol levels are among the many metabolic alterations closely related to this condition. Age, gender, genetics, and ethnicity are broad etiological factors contributing to variation in visceral adipose tissue accumulation. Specific mechanisms responsible for proportionally increased visceral fat storage when facing positive energy balance and weight gain may involve sex hormones, local cortisol production in abdominal adipose tissues, endocannabinoids, growth hormone, and dietary fructose. Physiological characteristics of abdominal adipose tissues such as adipocyte size and number, lipolytic responsiveness, lipid storage capacity, and inflammatory cytokine production are significant correlates and even possible determinants of the increased cardiometabolic risk associated with visceral obesity. Thiazolidinediones, estrogen replacement in postmenopausal women, and testosterone replacement in androgen-deficient men have been shown to favorably modulate body fat distribution and cardiometabolic risk to various degrees. However, some of these therapies must now be considered in the context of their serious side effects. Lifestyle interventions leading to weight loss generally induce preferential mobilization of visceral fat. In clinical practice, measuring waist circumference in addition to the body mass index could be helpful for the identification and management of a subgroup of overweight or obese patients at high cardiometabolic risk.

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Section: E Cancersmentioning

confidence: 88%

Pathophysiology of Human Visceral Obesity: An Update

Tchernof

Després

2013

Physiological Reviews

1,985

1,613

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show abstract

“…Of these studies, 12 were excluded for various reasons: 3 used other variable definitions of obesity [2,12,13]; 5 compared outcomes in tertiles or quartiles of BMI [14][15][16][17][18]; 1 evaluated the clinical outcomes of patients with morbidly obese [19]; and 2 were review [1,20]. In total, eight observational studies published between 2002 and 2009 matched the inclusion criteria and were therefore included [4-9, 21, 22].…”

Section: Selection Of Studiesmentioning

confidence: 99%

Outcome of laparoscopic colorectal surgery in obese and nonobese patients: a meta-analysis

Zhou

et al. 2011

Surg Endosc

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“…However, the benefits of the MIS approach in obese patients are less established [6][7][8][9]. Because obesity may increase operative time and difficulty, there could be a greater risk of subsequent infection or other complications even when using a minimally invasive approach [10,11]. Since complications are more likely to occur after complex surgeries, we examined both MIS and open surgery for rectal cancer to determine if increasing body mass index (BMI) was associated with increased postoperative complications.…”

Section: Introductionmentioning

confidence: 99%