Luke Martin1, Gillian Seton1, Booth Aldred2, Paul Hopkins3, Jessica Chan2, Marta E Heilbrun2, Mary Mone1, Courtney Scaife1, William Peche4. 1. Department of Surgery, University of Utah, Salt Lake City, UT, USA. 2. Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA. 3. Study Design and Biostatistics Center, University of Utah, Salt Lake City, UT, USA. 4. Department of Surgery, University of Utah, Salt Lake City, UT, USA. Electronic address: William.Peche@hsc.utah.edu.
Abstract
BACKGROUND: Obesity has been associated with worse outcomes and increased surgical technical difficulty. Perinephric fat (PNF) and periumbilical fat (PUF) are alternative metrics to body mass index. We hypothesized that PUF and PNF would offer improved prediction of perioperative risk. METHODS: 249 patients were retrospectively reviewed after elective, pelvic colorectal resections. PNF and PUF were collected using axial imaging. Operative risk measurements included estimated blood loss (EBL) and operative time (OT). RESULTS: In multivariate analyses of women, PUF and PNF were significant predictors of EBL; PNF was a significant predictor of OT. A 4.7-mm increase in PNF predicted a 15-minute increase in OT and 55-cc increase in EBL. An 8.6-mm increase in PUF predicted a 55-cc increase in EBL. In men, no metric was predictive. CONCLUSIONS: In women, PNF and PUF may offer improved metrics for risk stratification, which can have important clinical and financial implications. Published by Elsevier Inc.
BACKGROUND: Obesity has been associated with worse outcomes and increased surgical technical difficulty. Perinephric fat (PNF) and periumbilical fat (PUF) are alternative metrics to body mass index. We hypothesized that PUF and PNF would offer improved prediction of perioperative risk. METHODS: 249 patients were retrospectively reviewed after elective, pelvic colorectal resections. PNF and PUF were collected using axial imaging. Operative risk measurements included estimated blood loss (EBL) and operative time (OT). RESULTS: In multivariate analyses of women, PUF and PNF were significant predictors of EBL; PNF was a significant predictor of OT. A 4.7-mm increase in PNF predicted a 15-minute increase in OT and 55-cc increase in EBL. An 8.6-mm increase in PUF predicted a 55-cc increase in EBL. In men, no metric was predictive. CONCLUSIONS: In women, PNF and PUF may offer improved metrics for risk stratification, which can have important clinical and financial implications. Published by Elsevier Inc.
Entities:
Keywords:
Body mass index; Colorectal surgery; Obesity; Perinephric fat; Perioperative risk assessment; Periumbilical fat