Perirenal fat surface area as a risk factor for perioperative difficulties and 30‐day postoperative complications in elective colon cancer surgery

Hagopian, Olof S der; Dahlberg, Martin; Heinius, Göran; Nordberg, Jonas; Gustafsson, Johan; Nordenvall, Caroline; Sandblom, Gabriel; Farahnak, Parastou; Everhov, Åsa H

doi:10.1111/codi.14322

Cited by 8 publications

(4 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…21,45 From a technical perspective, greater abdominal adiposity has been associated with longer operation time and higher blood loss, increasing patients' risk of having complications, 21 all of which could contribute to risk of complication, readmission, or prolonged LOS. [46][47][48][49][50] Although preoperative therapy is increasingly recognized as an essential component of surgical care, 51 to our knowledge, only few physical and nutritional intervention studies have been conducted before CRC surgery. 52,53 In fact, the systematic review of these studies has not shown a significant reduction in postoperative complications or LOS.…”

Section: Discussionmentioning

confidence: 99%

“…Acting as a metabolic organ, adipose tissue participates in the inflammatory process by secreting a variety of cytokines that potentially inhibit the healing process and promote infection following surgery . From a technical perspective, greater abdominal adiposity has been associated with longer operation time and higher blood loss, increasing patients’ risk of having complications, all of which could contribute to risk of complication, readmission, or prolonged LOS …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Association of Low Muscle Mass and Low Muscle Radiodensity With Morbidity and Mortality for Colon Cancer Surgery

et al. 2020

View full text Add to dashboard Cite

IMPORTANCE Given the risks of postoperative morbidity and its consequent economic burden and impairment to patients undergoing colon resection, evaluating risk factors associated with complications will allow risk stratification and the targeting of supportive interventions. Evaluation of muscle characteristics is an emerging area for improving preoperative risk stratification.OBJECTIVE To examine the associations of muscle characteristics with postoperative complications, length of hospital stay (LOS), readmission, and mortality in patients with colon cancer. DESIGN, SETTING, AND PARTICIPANTSThis population-based retrospective cohort study was conducted among 1630 patients who received a diagnosis of stage I to III colon cancer from January 2006 to December 2011 at Kaiser Permanente Northern California, an integrated health care system. Preliminary data analysis started in 2017. Because major complication data were collected between 2018 and 2019, the final analysis using the current cohort was conducted between 2019 and 2020.EXPOSURES Low skeletal muscle index (SMI) and/or low skeletal muscle radiodensity (SMD) levels were assessed using preoperative computerized tomography images. MAIN OUTCOMES AND MEASURESLength of stay, any complication (Ն1 predefined complications) or major complications (Clavien-Dindo classification score Ն3), 30-day mortality and readmission up to 30 days postdischarge, and overall mortality. RESULTSThe mean (SD) age at diagnosis was 64.0 (11.3) years and 906 (55.6%) were women. Patients with low SMI or low SMD were more likely to remain hospitalized 7 days or longer after surgery (odds ratio [OR], 1.33; 95% CI, 1.05-1.68; OR, 1.39; 95% CI, 1.05-1.84, respectively) and had higher risks of overall mortality (hazard ratio, 1.40; 95% CI, 1.13-1.74; hazard ratio, 1.44; 95% CI, 1.12-1.85, respectively). Additionally, patients with low SMI were more likely to have 1 or more postsurgical complications (OR, 1.31; 95% CI, 1.04-1.65) and had higher risk of 30-day mortality (OR, 4.85; 95% CI,. Low SMD was associated with higher odds of having major complications (OR, 2.41; 95% CI, 1.44-4.04).CONCLUSIONS AND RELEVANCE Low SMI and low SMD were associated with longer LOS, higher risk of postsurgical complications, and short-term and long-term mortality. Research should evaluate whether targeting potentially modifiable factors preoperatively, such as preserving muscle mass, could reverse the observed negative associations with postoperative outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Association of Low Muscle Mass and Low Muscle Radiodensity With Morbidity and Mortality for Colon Cancer Surgery

et al. 2020

View full text Add to dashboard Cite

show abstract

“…[21] Jung et al [1] showed that perirenal fat surface area has a higher predictive value for postoperative outcomes in colorectal surgery than BMI and waist-to-hip ratio. der Hagopian et al [22] reported in their study that perirenal fat surface area, which is an indirect marker of visceral obesity, is associated with complications and can serve as a useful tool for preoperative risk assessment.…”

Section: Discussionmentioning

confidence: 99%

Perirenal fat thickness as a risk factor for postoperative complications in elective colorectal cancer surgery

Sönmez,

Aydin,

Biçer

et al. 2023

Medicine

View full text Add to dashboard Cite

Visceral obesity is an important factor that increases the risk of complications after colorectal cancer surgery. As calculating visceral fat is difficult and time-consuming, more practical fat measurements that are not time-consuming have been introduced. This study aimed to investigate the effects of perirenal fat thickness on postoperative complications and prognosis in patients undergoing surgery for colorectal cancer. Perirenal fat thickness was measured from the dorsal aspect of the left kidney on preoperative computerized tomography of patients who underwent surgery for colorectal cancer. The effects of perirenal fat thickness on postoperative complications were investigated. Diagnostic test performance was examined using the Roc Curve test to determine the cutoff value for the perirenal fat thickness values according to the complication findings of the patients. The cutoff value of perirenal fat thickness was found to be above 25.1, according to the presence of complications in the patients. Those with a perirenal fat thickness greater than 25.1 mm were considered to have high perirenal fat thickness values, and those with a low perirenal fat thickness value were considered low. Multivariate analysis revealed that increased perirenal fat thickness is an independent risk factor for postoperative complications. We believe that perirenal fat thickness measurement, as an indicator of visceral fat volume, can be used to identify patients at high risk of developing complications after colorectal cancer surgery. This may change the disease management and affect the patient information process.

show abstract

“…Perirenal fat, measured using CT images, has been reported 11–13 as an easily reproducible, indirect measurement that correlates with visceral fat. These studies found an association between the volume of perirenal fat and postoperative complications after colorectal surgery, but this association has not been investigated in surgery for gastric cancer.…”

Section: Introductionmentioning

confidence: 99%

Perirenal fat thickness as a predictor of postoperative complications after laparoscopic distal gastrectomy for gastric cancer

et al. 2020

View full text Add to dashboard Cite

Background: Laparoscopic distal gastrectomy is used widely in surgery for gastric cancer. Excess visceral fat can limit the ability to dissect the suprapancreatic region, potentially increasing the risk of local complications, particularly pancreatic fistula. This study evaluated perirenal fat thickness as a surrogate for visceral fat to see whether this was related to complications after laparoscopic distal gastrectomy. Methods: Perirenal fat thickness was measured dorsal to the left kidney as an indicator of visceral fat in patients with gastric cancer who underwent laparoscopic distal gastrectomy. Patients were divided into two groups: those with and those without complications. The relationship between perirenal fat thickness and postoperative complications was evaluated. Results: The optimal cutoff value for predicting morbidity using adipose tissue thickness was 10⋅7 mm; a distance equal to or greater than this was considered a positive perirenal fat thickness sign (PTS). A positive PTS showed a significant correlation with visceral fat area. Multivariable analysis found that a positive PTS was an independent risk factor for complications (hazard ratio 4⋅42, 95 per cent c.i. 2⋅31 to 8⋅86; P < 0⋅001). Conclusion: Perirenal fat thickness as an indicator of visceral fat was an independent predictor of postoperative complications after laparoscopic distal gastrectomy for gastric cancer.

show abstract

Perirenal fat surface area as a risk factor for perioperative difficulties and 30‐day postoperative complications in elective colon cancer surgery

Abstract: PRF, an easily measured indirect marker of visceral obesity, was associated with overall and moderate complications in men and women and could serve as a useful tool in the assessment of preoperative risk.

Cited by 8 publications

References 40 publications

Association of Low Muscle Mass and Low Muscle Radiodensity With Morbidity and Mortality for Colon Cancer Surgery

Association of Low Muscle Mass and Low Muscle Radiodensity With Morbidity and Mortality for Colon Cancer Surgery

Perirenal fat thickness as a risk factor for postoperative complications in elective colorectal cancer surgery

Perirenal fat thickness as a predictor of postoperative complications after laparoscopic distal gastrectomy for gastric cancer

Contact Info

Product

Resources

About