Obesity Does Not Impact Perioperative or Postoperative Outcomes in Patients with Inflammatory Bowel Disease

Guardado, Jesse; Carchman, Evie H.; Danicic, Ashley E.; Salgado, Javier; Watson, Andrew; Celebrezze, James; Medich, David S.; Holder-Murray, Jennifer

doi:10.1007/s11605-015-3060-4

Cited by 24 publications

(18 citation statements)

References 27 publications

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“…Although some studies have not found obesity to influence all of these complications, the association of obesity with prolonged operative time has consistently been recognized . Obesity reportedly does not influence intraoperative variables or postoperative complications in patients with inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis, undergoing gastrointestinal surgical resection …”

Section: Colorectal Surgerymentioning

confidence: 99%

Obesity as a surgical risk factor

Aikou

Seto

2017

Annals of Gastroent Surgery

157

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In recent years, both the actual number of overweight/obese individuals and their proportion of the population have steadily been rising worldwide and obesity‐related diseases have become major health concerns. In addition, as obesity is associated with an increased incidence of gastroenterological cancer, the number of obese patients has also been increasing in the field of gastroenterological surgery. While the influence of obesity on gastroenterological surgery has been widely studied, very few reports have focused on individual organs or surgical procedures, using a cross‐sectional study design. In the present review, we aimed to summarize the impacts of obesity on surgeries for the esophagus, stomach, colorectum, liver and pancreas. In general, obesity prolongs operative time. As to short‐term postoperative outcomes, obesity might be a risk for certain complications, depending on the procedure carried out. In contrast, it is possible that obesity doesn't adversely impact long‐term surgical outcomes. The influences of obesity on surgery are made even more complex by various categories of operative outcomes, surgical procedures, and differences in obesity among races. Therefore, it is important to appropriately evaluate perioperative risk factors, including obesity.

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Section: Colorectal Surgerymentioning

confidence: 99%

Obesity as a surgical risk factor

Aikou

Seto

2017

Annals of Gastroent Surgery

157

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“…Several studies have shown association of obesity with increased operative times, increased blood loss, and a higher risk of conversion from laparoscopic to open surgeries 20,21 . In contrast to this, a retrospective cohort study including 391 IBD patients undergoing surgery found that 30-day postoperative complication rates including total complications, wound infection, or anastomotic leak did not vary according to BMI 22 . The inconsistency of these studies may because that they did not evaluate further into visceral obesity, which is a more representative parameter of body fat.…”

Section: Discussionmentioning

confidence: 62%

Impact of Visceral Obesity on Chronic Obstipation, Inflammation, Immune Function and Cognitive Function Among Patients with Inflammatory Bowel Disease

Wan

Zhang

Qian

et al. 2020

Preprint

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Background: Obesity has gained attention among patients with inflammatory bowel disease (IBD). The impact of visceral obesity on chronic obstipation, inflammation, immune function and cognition after diagnosis of IBD is still unknown.Methods: This is a cross-sectional study of 140 IBD patients. Patients’ visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were measured by abdominal computerized tomography (CT) scans and were grouped according to visceral obesity. Baseline variables, chronic obstipation status, inflammation status and immune function were compared. The implications of visceral obesity on cognitive function were evaluated using Mini-Mental State Examination (MMSE).Results: The prevalence of visceral obesity was 51% (37 out of 72) for CD patients and 26% for UC patients (18 out of 68 patients). CD patients with visceral obesity has higher incidence of chronic obstipation (81% vs. 57%, P = 0.028), higher IL-6 levels (9.3 vs. 6.0 pg/ml, P = 0.045) and lower CD4+ T cells (32.7% vs. 44.0%, P = 0.034). For UC patients, patients with visceral obesity have the tendency of higher IL-6 levels (7.2 vs. 6.0 pg/ml, P = 0.053).Conclusion: IBD patients had high risks of visceral obesity. Patients with visceral obesity had higher prevalence of chronic obstipation, higher inflammation levels, decreased immune function.

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“…Male gender and higher BMI were identified as independent risk factors for PRC. Guardado et al [10] reported that higher BMI (≥30) did not appear to affect intraoperative variables such as estimated blood loss and mean operative time; BMI also did not appear to worsen postoperative complications in UC and CD patients. Krane et al [13] reported that higher BMI (≥25) increased the amount of hemorrhaging and the operative duration but made no difference in postoperative outcomes in IBD patients, including patients with UC and CD.…”

Section: Discussionmentioning

confidence: 94%

“…However, data on the influence of higher BMI on perioperative outcomes in patients with IBD are sparse and controversial. Higher BMI increased the risk of postoperative complications following restorative proctocolectomy with an ileal pouch-anal anastomosis (IPAA), but higher BMI did not appear to impact intraoperative variables; also, higher BMI did not appear to worsen postoperative complication rates in UC and CD patients [9,10].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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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.

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Obesity Does Not Impact Perioperative or Postoperative Outcomes in Patients with Inflammatory Bowel Disease

Abstract: Obesity does not appear to impact intraoperative variables nor does obesity appear to worsen postoperative complication rates in IBD patients.

Cited by 24 publications

References 27 publications

Obesity as a surgical risk factor

Obesity as a surgical risk factor

Impact of Visceral Obesity on Chronic Obstipation, Inflammation, Immune Function and Cognitive Function Among Patients with Inflammatory Bowel Disease

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

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