Salvatore Docimo1, Young Lee2, Prav Chatani2, Ann M Rogers3, Frank Lacqua2. 1. Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook Medicine, Stony Brook, NY, USA. sdocimo@gmail.com. 2. Department of Surgery, NYU Lutheran Medical Center, Brooklyn, NY, USA. 3. Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Penn State Hershey Medical Center, Hershey, PA, USA.
Abstract
INTRODUCTION: There is an association between obesity and more complicated diverticular disease. We hypothesize that this link may be due to an increased level of visceral fat rather than an elevated body mass index alone. Adipose tissue secretes inflammatory cytokines, and chronic inflammation may account for the link between obesity and a more severe presentation of diverticular disease. We have applied a quantitative measure of visceral fat content in a series of patients admitted with diverticulitis, comparing those who required emergent versus elective surgical procedures for diverticulitis. METHODS: We performed a retrospective review of all adult patients who underwent emergent or elective surgery at our institution for diverticulitis from 2010 to 2014. Data were collected on demographics, comorbidities, operative findings, complications, and length of stay. Radiologic measurements of adiposity were obtained from preoperative CT scans. Visceral fat areas and subcutaneous fat areas were measured, and the V/S ratio was calculated. RESULTS: Thirty-four patients underwent emergent and 32 patients underwent elective surgery. The mean age was 66.3 years for the emergent and 57.11 for the elective group (p = 0.04178). The perinephric, visceral, subcutaneous fat, and V/S ratio for the emergent group were 1.71, 185.22, 338.22, and 0.56 and were 1.11, 127.18, 295.28, and 0.46 for the elective group. The difference between the V/S ratio for each group was significant (p = 0.0238). The emergent group had an average LOS of 16.11 days compared to 5.15 for the elective group (p = <0.00001). The complication rate was significantly higher (p = 0.024) in the emergent group (n = 12, 35.2 %) compared to the elective group (n = 4, 12.5 %). CONCLUSION: Our study demonstrates a clinically significant link between visceral fat and severity of presentation of diverticulitis. Patients with higher V/S fat ratios were more likely to require emergency surgery and have more complications and a longer LOS.
INTRODUCTION: There is an association between obesity and more complicated diverticular disease. We hypothesize that this link may be due to an increased level of visceral fat rather than an elevated body mass index alone. Adipose tissue secretes inflammatory cytokines, and chronic inflammation may account for the link between obesity and a more severe presentation of diverticular disease. We have applied a quantitative measure of visceral fat content in a series of patients admitted with diverticulitis, comparing those who required emergent versus elective surgical procedures for diverticulitis. METHODS: We performed a retrospective review of all adult patients who underwent emergent or elective surgery at our institution for diverticulitis from 2010 to 2014. Data were collected on demographics, comorbidities, operative findings, complications, and length of stay. Radiologic measurements of adiposity were obtained from preoperative CT scans. Visceral fat areas and subcutaneous fat areas were measured, and the V/S ratio was calculated. RESULTS: Thirty-four patients underwent emergent and 32 patients underwent elective surgery. The mean age was 66.3 years for the emergent and 57.11 for the elective group (p = 0.04178). The perinephric, visceral, subcutaneous fat, and V/S ratio for the emergent group were 1.71, 185.22, 338.22, and 0.56 and were 1.11, 127.18, 295.28, and 0.46 for the elective group. The difference between the V/S ratio for each group was significant (p = 0.0238). The emergent group had an average LOS of 16.11 days compared to 5.15 for the elective group (p = <0.00001). The complication rate was significantly higher (p = 0.024) in the emergent group (n = 12, 35.2 %) compared to the elective group (n = 4, 12.5 %). CONCLUSION: Our study demonstrates a clinically significant link between visceral fat and severity of presentation of diverticulitis. Patients with higher V/S fat ratios were more likely to require emergency surgery and have more complications and a longer LOS.
Authors: Anna M I Gradmark; Anders Rydh; Frida Renström; Emanuella De Lucia-Rolfe; Alison Sleigh; Peter Nordström; Soren Brage; Paul W Franks Journal: Br J Nutr Date: 2010-04-07 Impact factor: 3.718
Authors: Ravi V Shah; Venkatesh L Murthy; Siddique A Abbasi; Ron Blankstein; Raymond Y Kwong; Allison B Goldfine; Michael Jerosch-Herold; João A C Lima; Jingzhong Ding; Matthew A Allison Journal: JACC Cardiovasc Imaging Date: 2014-11-05
Authors: Jae Hak Kim; Jae Hee Cheon; Sooyoung Park; Byung Chang Kim; Sang Kil Lee; Tae Il Kim; Won Ho Kim Journal: Hepatogastroenterology Date: 2008 May-Jun
Authors: Wenjie Ma; Manol Jovani; Po-Hong Liu; Long H Nguyen; Yin Cao; Idy Tam; Kana Wu; Edward L Giovannucci; Lisa L Strate; Andrew T Chan Journal: Gastroenterology Date: 2018-04-01 Impact factor: 22.682