Abstract
The impact of visceral obesity on perioperative outcome in laparoscopic colorectal surgery is still inconclusive. Various studies have taken different parameters to define visceral obesity. The aim of our study was to find the impact of visceral fat volume (VFV) on perioperative outcome in laparoscopic colorectal surgery. The primary objective of our study was to find the correlation of VFV within postoperative complications. Sixty-five patients with colorectal cancer who underwent elective laparoscopic colorectal surgery were included in the study. We assessed the VFV from a CT scan of the abdomen and pelvis using FUJIFILM: SYNAPSE 3D software. Patients were divided as per percentiles into three groups < 25th: low; 25th-75th moderate and > 75th High VFV. Intraoperative difficulties were assessed based on the surgeon's subjective scoring of difficulty, operative time, estimated blood loss, and conversion to open surgery. Postoperative outcomes were measured in terms of time to start an oral semisolid diet, length of hospital stay, surgical site infections, and overall 30-day morbidity according to the Clavien Dindo classification. Data was analysed to identify the effect of visceral fat volume on perioperative outcomes in laparoscopic colorectal surgeries. The overall rate of major complications (i.e. > grade II Clavien Dindo) was 21.5%. Moderate and high VFV groups had 28.12% and 31.25% major complications, respectively. The correlation of VFV with major complications was found to be significant with p 0.04. Overall operative time was 252.24 min, 289.31 min, and 301.44 min in low, moderate, and high VFV groups, respectively (p-value of < 0.005). High VFV had statistically significant blood loss measured as haemoglobin mass loss of 88.84 gm as compared to 44.5 gm and 57.19 gm in low and moderate. Subjective scores of difficulty were also higher in high VFV as compared to moderate and low VFV groups but higher VFV had no direct relation with conversion to open surgery. VFV had no direct effect on post-operative time to start a semi-solid diet and length of hospital stay. High VFV had a higher inflammatory response postoperatively measured as a higher CRP value but was not statistically significant. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13193-025-02269-w.