Annals of Coloproctology

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Minimally invasive surgery

Body composition index obtained by using a bioelectrical impedance analysis device can be a predictor of prolonged operative time in patients undergoing minimally invasive colorectal surgery: Ho Seung Kim, Kwang Ho Kim, Gyoung Tae Noh, Ryung-Ah Lee, Soon Sup Chung; Ann Coloproctol. 2023;39(4):342-350. Published online June 3, 2022; DOI: https://doi.org/10.3393/ac.2022.00262.0037

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Purpose
Obesity has been known to contribute to technical difficulties in surgery. Until now, body mass index (BMI) has been used to measure obesity. However, there are reports that BMI does not always correspond to the visceral fat. Recently, bioelectrical impedance analysis (BIA) has been used for body composition analysis. This study aimed to evaluate the usefulness of the body composition index obtained using a BIA device in predicting short-term postoperative outcomes.
Methods
Data of patients who underwent elective major colorectal surgery using minimally invasive techniques were reviewed retrospectively. Body composition status was recorded using a commercial BIA device the day before surgery. The relationship between BMI, body composition index, and short-term postoperative outcomes, including operative time, was analyzed.
Results
Sixty-six patients were enrolled in this study. In the correlation analysis, positive correlation was observed between BMI and body composition index. BMI and body composition index were not associated with short-term postoperative outcomes. Percent body fat (odds ratio, 4.226; 95% confidence interval [CI], 1.064–16.780; P=0.041) was found to be a statistically significant factor of prolonged operative time in the multivariate analysis. Correlation analysis showed that body fat mass was related to prolonged operative time (correlation coefficients, 0.245; P=0.048). In the area under curve analysis, body fat mass showed a statistically significant predictive probability for prolonged operative time (body fat mass: area, 0.662; 95% CI, 0.531–0.764; P=0.024).
Conclusion
The body composition index can be used as a predictive marker for prolonged operative time. Further studies are needed to determine its usefulness.

Citations

Citations to this article as recorded by

Pretreatment bioelectrical impedance analysis predicts chemotherapy efficacy and toxicity in metastatic colorectal cancer patients
Rikako Kato, Yuji Miyamoto, Yukiharu Hiyoshi, Yuto Maeda, Mayuko Ouchi, Katsuhiro Ogawa, Keisuke Kosumi, Kojiro Eto, Satoshi Ida, Masaaki Iwatsuki, Yoshifumi Baba, Hideo Baba
Clinical Nutrition ESPEN.2025; 66: 497. CrossRef
Simple perinephric adipose tissue measurement for prediction of failed sentinel lymph node mapping in endometrial cancer
Lina Salman, Paulina Cybulska, Ryley Fowler, Manjula Maganti, Ur Metser, Sarah E. Ferguson
International Journal of Gynecological Cancer.2025; 35(11): 101949. CrossRef
The Antibody Response to the BNT162b2 mRNA COVID-19 Booster in Healthcare Workers: Association between the IgG Antibody Titers and Anthropometric and Body Composition Parameters
Marlena Golec, Adam Konka, Martyna Fronczek, Joanna Zembala-John, Martyna Chrapiec, Karolina Wystyrk, Sławomir Kasperczyk, Zenon Brzoza, Rafał Jakub Bułdak
Vaccines.2022; 10(10): 1638. CrossRef

Benign GI diease

Factors Predicting the Need for Early Surgical Intervention for Small Bowel Obstruction: Young Jae Cho, In Seok Park, Jungbin Kim, Hyun Jin Cho, Geum Hee Gwak, Keun Ho Yang, Byung Noe Bae, Ki Hwan Kim; Ann Coloproctol. 2020;36(4):223-228. Published online January 31, 2020; DOI: https://doi.org/10.3393/ac.2019.09.30

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11 Web of Science
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Abstract PDF

Purpose
Small bowel obstruction (SBO) is a common disease that requires hospitalization. The most common cause of SBO is postoperative adhesion. Delayed timing of operations in patients who need surgical intervention results in mortality or morbidity. A number of studies on SBO have established criteria for emergency surgery. However, few objective clinical parameters are available for screening patients who need a delayed operation. Therefore, we analyzed factors that affect the clinical course of SBO to select appropriate therapeutic plans for reducing the risk of complications in these patients.
Methods
We investigated the clinical characteristics of patients admitted to the surgery department of our hospital between January 1, 2015, and December 31, 2016, who were diagnosed with SBO. Patients were divided into an operative treatment group (n = 12) and a conservative treatment group (n = 96). We compared clinical characteristics between the 2 groups.
Results
The operative treatment group underwent more operations before SBO than the conservative treatment group (P = 0.007). Initial leukocyte counts (P = 0.004) and C-reactive protein (CRP) levels (P = 0.028) were elevated in the operative group. Body mass index (BMI) was lower in the operative group (P = 0.013).
Conclusion
The number of operations before SBO, leukocyte counts, CRP levels, and BMI were useful parameters for selecting patients who needed an urgent operation for SBO.

Citations

Citations to this article as recorded by

Postoperative morbidity following surgery for mechanical adhesive small bowel obstruction: prevalence, risk factors and clinical outcomes
Timur Buniatov, Matthias Maak, Axel Denz, Christian Krautz, Georg F. Weber, Robert Grützmann, Anke Mittelstädt, Maximilian Brunner
BMC Surgery.2026;[Epub] CrossRef
Correlates of Markedly Elevated C-reactive Protein >200 mg/L and Its Prognostic Role in Intensive Care Unit Admission and Mortality: A Record-based Retrospective Study
Avelyn Thazhuthadath Kishore, Rosmi Jose
Journal of Applied Sciences and Clinical Practice.2025; 6(1): 32. CrossRef
Chronic Comorbidities and Failure of Non-Operative Management in Adhesive Small Bowel Obstruction: Results of Analysis of National Inpatient Data from the United States
Gal Malkiely, Maya Paran, Miri Elgabsi, Boris Kessel
Journal of Clinical Medicine.2025; 14(17): 5989. CrossRef
Prediction and Risk Evaluation for Surgical Intervention in Small Bowel Obstruction †
Timur Buniatov, Matthias Maak, Anne Jacobsen, Franziska Czubayko, Axel Denz, Christian Krautz, Georg F. Weber, Robert Grützmann, Maximilian Brunner, Anke Mittelstädt
Journal of Clinical Medicine.2025; 15(1): 297. CrossRef
The predictive role of computed tomography with oral contrast in the successful management of adhesive small bowel obstruction
Mohamed Khattab, Amr Ayad, Sameh Aziz, Peter Alaa, Marie N. Grace, Mohamed Saber
The Egyptian Journal of Surgery.2024; 43(1): 16. CrossRef
Associated factors with non operative management failure in bowel obstruction
Omar Gutierrez Moreno, Nicolas Arredondo Mora, Oscar Rincon Barbosa, Francisco Gil Quintero
Surgery Open Digestive Advance.2024; 16: 100185. CrossRef
Preventable diagnostic errors of lower gastrointestinal perforation: a secondary analysis of a large-scale multicenter retrospective study
Taku Harada, Takashi Watari, Satoshi Watanuki, Seiko Kushiro, Taiju Miyagami, Syunsuke Syusa, Satoshi Suzuki, Tetsuya Hiyoshi, Suguru Hasegawa, Shigeki Nabeshima, Hidetoshi Aihara, Shun Yamashita, Masaki Tago, Fumitaka Yoshimura, Kotaro Kunitomo, Takahiro
International Journal of Emergency Medicine.2024;[Epub] CrossRef
Clinical and Radiological Factors Associated with Nonoperative Management Failure for Small Bowel Obstruction: A Retrospective Study from a Resource-Limited Setting
Saleh Al-wageeh, Qasem Alyhari, Faisal Ahmed, Hanan Mohammed, Noha Dahan, Abdullatif Almohtadi, Sameer AL-Nuzili, Mohamed Badheeb, Abdulsattar Naji
Therapeutics and Clinical Risk Management.2024; Volume 20: 893. CrossRef
Development of a predictive model for the need for early surgery in patients with adhesive small-bowel obstruction
Yanhao Sun, Yilong Hu, Yuanfang Sun
Journal of International Medical Research.2024;[Epub] CrossRef
Predictive factors for operative intervention and ideal length of non-operative trial in adhesive small bowel obstruction
Tara van Veen, Purushotham Ramanathan, Lolita Ramsey, Jonathan Dort, Dina Tabello
Surgical Endoscopy.2023; 37(11): 8628. CrossRef
Surgical management of adhesive small bowel obstruction: Is it still mandatory to wait? – An update
R. Demessence, Y. Lyoubi, F. Feuerstoss, A. Hamy, C. Aubé, A. Paisant, A. Venara
Journal of Visceral Surgery.2022; 159(4): 309. CrossRef
Prise en charge chirurgicale des syndromes occlusifs de l’intestin grêle sur bride et adhérences postopératoires : faut-il toujours attendre ?
R. Demessence, Y. Lyoubi, F. Feuerstoss, A. Hamy, C. Aubé, A. Paisant, A. Venara
Journal de Chirurgie Viscérale.2022; 159(4): 326. CrossRef
Small bowel obstruction
David J. Detz, Jerica L. Podrat, Jose C. Muniz Castro, Yoon K. Lee, Feibi Zheng, Shawn Purnell, Kevin Y. Pei
Current Problems in Surgery.2021; 58(7): 100893. CrossRef

Preoperative Body Mass Index, 30-Day Postoperative Morbidity, Length of Stay and Quality of Life in Patients Undergoing Pelvic Exenteration Surgery for Recurrent and Locally-Advanced Rectal Cancer: Jessica Beaton, Sharon Carey, Michael J Solomon, Ker-Kan Tan, Jane Young; Ann Coloproctol. 2014;30(2):83-87. Published online April 25, 2014; DOI: https://doi.org/10.3393/ac.2014.30.2.83

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20 Web of Science
22 Citations

Abstract PDF

Purpose

Malnutrition is associated with an increased risk of developing complications following gastrointestinal surgery, especially following radical surgeries such as pelvic exenteration. This study aims to determine if preoperative body mass index (BMI) is associated with 30-day morbidity, length of hospital stay and/or quality of life (QoL) in patients undergoing pelvic exenteration surgery for recurrent and locally-advanced rectal cancer prior to a prospective trial.

Methods

A review of all patients who underwent pelvic exenteration surgery prior to 2008 was performed. Patients were included if they had a documented BMI as well as a QoL measurement (Functional Assessment Cancer Therapy - Colorectal questionnaire).

Results

Thirty-one patients, with a mean age of 56 years, had preoperative height and weight data, as well as measures of postoperative QoL, and formed the study group. The numbers of patients with recurrent (n = 17) or locally-advanced rectal cancer (n = 14) were similar. The mean length of stay was 21 days while the mean BMI of the patients was 24.3 (± 5.9) kg/m². The majority of the patients were either of normal weight (n = 15) or overweight/obese (n = 11). The average length of hospital stay was significantly longer in patients who were underweight compared to those who were of normal weight (F = 6.508, P = 0.006) and those who were overweight and obese (F = 6.508, P = 0.007).

Conclusion

This study suggests that a lower body mass index preoperatively is associated with a longer length of hospital stay. BMI is not associated with long-term QoL in this patient group. However, further prospective research is required.

Citations

Citations to this article as recorded by

Prospective longitudinal trajectory of cancer survivorship among patients with recurrent rectal cancer: impact of treatment modalities and resection status
Tarik Sammour, Oliver Peacock, Brian K. Bednarski, Arvind Dasari, Prajnan Das, Benny Johnson, Grace L. Smith, George J. Chang, John Skibber, Y. Nancy You
Colorectal Disease.2025;[Epub] CrossRef
Living After Pelvic Exenteration: A Mixed-Methods Synthesis of Quality-of-Life Outcomes and Patient Perspectives
Vlad Rotaru, Elena Chitoran, Aisa Gelal, Giuseppe Gullo, Daniela-Cristina Stefan, Laurentiu Simion
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Systematic Review of Patient-Reported Outcome Measures in Locally Recurrent Rectal Cancer
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Annals of Surgical Oncology.2023; 30(7): 3969. CrossRef
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N.J. Lyell, M. Kitano, B. Smith, A.L. Gleisner, F.J. Backes, G. Cheng, M.D. McCarter, S. Abdel-Misih, E.L. Jones
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Preoperative Nutrition Status and Postoperative Outcomes in Patients Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
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Ying Guo, Eugene Chang, Mehtap Bozkurt, Minjeong Park, Diane Liu, Jack B. Fu
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Impact of Body Mass Index on Surgical Outcomes of Laparoscopic Colorectal Cancer Resection.: Joh, Yong Geul , Kim, Seon Han , Yoon, Jin Seok , Chung, Choon Sik , Lee, Dong Keun; J Korean Soc Coloproctol. 2003;19(4):243-247.

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Abstract PDF: PURPOSE
The purpose of this study was to determine whether obesity increases the risk of performing a laparoscopic resection for colorectal cancer.
METHODS
Prospectively collected data were obtained for 103 patients who had undergone laparoscopic resection for colorectal cancer from September 2001 to August 2002. Patients who had had a previous abdominal operation, a total colectomy or an additional surgical procedure at the time of colon resection were excluded from the analysis. The patients were divided into two groups based on body mass index (BMI kg/m2): the normal group (BMI <25) and the obesity group (BMI 25). Intraoperative blood loss, operative time, conversion, length of hospital stay and complications were analyzed.
RESULTS
Nineteen patients (25%) were obese. Operation time (183.2 min vs 202.1 min) and the blood loss (98.2 ml vs 168.2 ml) were significantly increased in the obese patients, but hospital discharge after surgery (11.7 days vs 11.9 days) and the morbidity rate (8.5% vs 5.3%) were not different between the groups. Conversion to the an open precedure occurred with one obese patient, but that was not related to obesity. In the analysis of the low anterior resection, blood loss (94.6 ml vs 186.6 ml) was significantly higher in obese patients, but no statistically significant differences existed for other surgical outcomes between the two groups.
CONCLUSIONS
A laparoscopic resection for colorectal cancer can be safely performed in obese patients.

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