Impact of visceral obesity on outcomes of laparoscopic colorectal surgery: a meta-analysis

Background: Excessive visceral fat could influence surgical difficulty of laparoscopic colorectal surgery. With the use of visceral fat area measured by computed tomography, surgeons could quantify the amount of visceral fat. The aim of the present meta-analysis is to quantitatively combine studies in order to determine the impact of visceral obesity on laparoscopic colorectal surgery.

Methods: A systematic search of literature (PubMed, EMBASE, the Cochrane Library) was performed to identify studies evaluating the impact of visceral obesity on laparoscopic colorectal surgery.

Results: Four studies were included in this meta-analysis. Meta-analysis revealed that visceral obesity was associated with longer operative time (weighted mean difference (WMD) 24.42, 95% confidence interval (CI) 12.98-35.86), less lymph nodes harvest (WMD -5.99, 95% CI -8.31 to -3.67), more conversion to open procedure (odds ratio (OR) 2.24, 95% CI 1.05-4.78), higher morbidity (OR 2.33, 95% CI 1.56-3.48), more surgical site infection (OR 3.22, 95% CI 1.95-5.32) and more anastomotic leakage (OR 2.40, 95% CI 1.06-5.44).

Conclusion: The present study shows that visceral obesity is associated with increased surgical difficulty and post-operative morbidity of laparoscopic colorectal surgery but does not affect post-operative recovery thanks to laparoscopic procedure.