More fat around internal organs may mean more complications after liver surgery

PharmaLive.com (16 November 2010) - amount of intra-abdominal fat seems to be associated with the risk of complications after major surgery of the liver, according to an article published in the November issue of the archives of surgery, one of the JAMA/Archives Journals. However, appearing in overweight or who have a high body mass index (BMI) were not associated with increased post-operative risk.

Approximately 65% of the u.s. population is currently overweight, half of those eligible as obese, according to background information in the article. Increase the frequency of obesity "surgeons review requires more critical of the effect of overweight and obesity on their patients," write the authors. " Literature currently presents mixed conclusions about the effect of overweight and obesity on various surgical populations with different measures of obesity used in these studies.»

Katherine Morris, M.D. and his colleagues at Memorial Sloan - Kettering Cancer Center in New York, studied 349 patients undergoing a surgical removal of part of the liver from June 1996 and November 2001. Computed tomography (CT) analysis before surgery were used to estimate the amount of fat as perinephritic, a measure of fat around the kidneys, which has been used as a substitute for the intra-abdominal fat.In addition, BMI patients was calculated using data size and poids.Les authors have also used computed tomography to measure external abdominal fat. Complications were followed by the cancer centre database.

After the major operations of liver, 230 patients (65.9%) have complications and nine (2.6%) patients died.The average duration of hospital stay was 10.8 days.

As measured by the amount of grease around the kidney patients with intra-abdominal fat than were more likely to have complications, including serious complications, longer length of hospital stay, and were more likely to die within 30 days that patients with less material grasses.Les patients with a higher mass index (BMI) body had procedures which took over time; However, BMI and external abdominal fat measures not were not associated with complications rate, the onset of serious complications, the duration of the stay or the risk of death within 30 days.

IMC appears to be a poor measure obesity puts abdominal surgery patients at risk type, the authors note.""As defined as perinephritic grease unique and simple substitution, intra-abdominal fat could serve as a risk stratifying patients for mortality, the rate of complication, severity of complications and increasing length of stay," they write.

"This should help surgeons be better able to identify patients at high risk and, conversely, not reject a transaction based on the presumed someone external obesity risk."Now that most of our patients taken into account for a major upper abdominal resection will preoperative CT scan, provided as perinephritic looking fat rich information is easily determined and should not be ignored.

Editor's note: this article is not intended to provide medical advice, diagnosis or treatment.

Source of the story:

The story above is reproduced (with drafting adaptations by staff at PharmaLive.com) materials provided by JAMA and archives of newspapers.

Reference of the review:

Katherine Morris.Scott Tuorto.Mithat pirates.Laurent Schwartz.Ronald DeMatteo.Michael of Angelica .William r. Jarnagin; Fong Yuman.Simple Intra-abdominal for predicting outcome of abdominal fat steps .Archives surgery, 2010; 145 (11): 1069-1073 DOI: 10.1001/archsurg.2010.222

Note: If no author is given, the source is cited for this.

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