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Sagittal Abdominal Diameter is a Better Predictor than Body Mass Index for Duration of Laparoscopic Left Colectomy

Clerc, Daniel ; Blaser, Benjamin ; Demartines, Nicolas ; Christoforidis, Dimitrios

In: World Journal of Surgery, 2015, vol. 39, no. 3, p. 769-775

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    Titre
    • Sagittal Abdominal Diameter is a Better Predictor than Body Mass Index for Duration of Laparoscopic Left Colectomy
    Auteur
    • Clerc, Daniel. Department of Visceral Surgery, CHUV, University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
    • Blaser, Benjamin. Department of Visceral Surgery, CHUV, University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
    • Demartines, Nicolas. Department of Visceral Surgery, CHUV, University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
    • Christoforidis, Dimitrios. Department of Visceral Surgery, CHUV, University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • World Journal of Surgery, 2015, vol. 39, no. 3, p. 769-775. Springer US; http://www.springer-ny.com
    Autre version électronique
    Classification
    • Santé
    Identifiant OAI-PMH
    • oai:doc.rero.ch:331205
    Summary
    Background: Visceral obesity (VO) increases technical difficulty in laparoscopic surgery. The body mass index (BMI) does not always correlate to intra-abdominal fat distribution. Our hypothesis was that simple anthropometric measures that reflect VO, could predict technical difficulty in laparoscopic colorectal surgery, as reflected by the operative time, more accurately than the BMI. Methods: Charts of all consecutive patients who underwent laparoscopic left colon resection in our institution between 2007 and 2010 were reviewed retrospectively. On a preoperative CT scan, anthropometric measures were taken on an axial plane at the L4-L5 level. Demographic, operative and anthropometric CT measures were correlated with the operative time. Logistic regression analysis was performed to assess the value of anthropometric CT measures or BMI to predict the duration of the colectomy. Results: 121 patients with elective left colon resection for benign (56%) or malignant disease (44%) were included. There were 74 sigmoid resections (61%), 21 left hemicolectomies (17%) and 26 low anterior resections (22%). A longer sagittal abdominal diameter (≥24.8cm) was significantly associated with longer corrected operative time (248 vs. 228min, p=0.043). In multivariate analysis, greater sagittal abdominal diameter, sagittal internal diameter and abdominal perimeter were significantly associated with longer operative time. No significant association was found for the BMI neither in univariate nor in multivariate analysis. Conclusions: This study suggests that simple linear measures taken on a CT scan, such as sagittal abdominal diameter, sagittal internal diameter and abdominal perimeter, may predict longer operative time in laparoscopic left colonic resections more accurately than BMI.