Visceral Obesity Predicts Surgical Outcomes after Laparoscopic Colectomy for Sigmoid Colon Cancer

Abstract: Purpose: This study was designed to assess whether visceral obesity is a more useful predictor of surgical outcomes compared with body mass index after laparoscopic colectomy. Methods: A total of 133 consecutive patients who underwent elective laparoscopic colectomy for sigmoid colon cancer between April 2001 and April 2007 were included. Obesity was defined by visceral fat area ≥130 cm² or body mass index ≥25 kg/m², and the variables were compared for obese and nonobese patients. Results: There were 68 (51.1 percent) obese patients according to visceral fat area and 27 (20.3 percent) according to body mass index. Using either definition, obese patients had a significantly longer operative time compared with nonobese patients. Patients classified as obese by visceral fat area had a significantly higher incidence of wound infection (20.6 vs. 4.6 percent; P = 0.006) and overall complication rates (32.4 vs. 12.3 percent, P = 0.006) compared with nonobese patients, whereas there was no significant difference when classified by body mass index. Postoperative hospital stay was significantly longer in obese patients compared with nonobese patients classified by visceral fat area (median 10.5 vs. 9 days; P = 0.007), whereas it was not statistically different when classified by body mass index. Conclusion: Visceral fat area is a more useful parameter than body mass index in predicting surgical outcomes after laparoscopic colectomy for sigmoid colon cancer.