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The effect of metabolic syndrome on postoperative outcomes following laparoscopic colectomy

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Abstract

Background

Among the criteria used to diagnose metabolic syndrome (MS), obesity and diabetes mellitus (DM) are associated with poor postoperative outcomes following colectomy. MS is also associated with colorectal cancer (CRC) and diverticulosis, both of which may be treated with colectomy. However, the effect of MS on postoperative outcomes following laparoscopic colectomy has yet to be clarified.

Methods

In an academic tertiary hospital, data from all consecutive patients undergoing laparoscopic colectomy from 2005 to 2014 were prospectively recorded and analysed. Patients presenting with MS [defined by the presence of three or more of the following criteria: elevated blood pressure, body mass index > 28 kg/m2, dyslipidemia (decreased serum HDL cholesterol, increased serum triglycerides) and increased fasting glucose/DM] were compared with patients without MS regarding peri-operative outcome [mainly anastomotic leaks, severe postoperative complications (Clavien–Dindo III and IV)] and mortality.

Results

Overall, 1236 patients were included: 508 (41.1%) right colectomies and 728 (58.9%) left colectomies. Seven hundred seventy-two (62.4%) of these procedures were performed for CRC. MS was diagnosed in 85 (6.9%) patients, who were significantly older than the others (70 vs. 64.2 years, p < 0.001), and presented with more cardiac comorbidities (p < 0.001). MS was associated with increased blood loss (122.5 vs. 79.9 mL p = 0.001) and blood transfusion requirement (5.9 vs. 1.7%, p = 0.021). The anastomotic leak rate was 6.6% (with 2.2% of anastomotic leaks requiring surgical treatment), and the overall reoperation rate was 6.9%. The incidence of severe postoperative complications was 11.5%, and the overall mortality rate 0.6%. No differences were found between the groups in overall postoperative morbidity and mortality. Median length of stay was similar in both groups (7 days).

Conclusions

MS does not jeopardize postoperative outcomes following laparoscopic colectomy.

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Authors and Affiliations

  1. Department of Digestive Surgery, Avicenne Hospital, Paris XIII University, 125, Rue de Stalingrad, 93000, Bobigny, France

    A. Zarzavadjian Le Bian & P. Wind

  2. Laboratory of Medical Ethics and Legal Medicine, Descartes University Paris, Paris, France

    A. Zarzavadjian Le Bian

  3. Department of Digestive Diseases, Mutualiste Montsouris Institute Paris, Paris, France

    C. Denet, N. Tabchouri, H. Levard, R. Besson, T. Perniceni, D. Fuks & B. Gayet

  4. Department of Surgery, University of Parma, Parma, Italy

    R. Costi

  5. Faculty of Medicine, Descartes University, Paris, France

    D. Fuks & B. Gayet

Authors
  1. A. Zarzavadjian Le Bian
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  2. C. Denet
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  3. N. Tabchouri
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  4. H. Levard
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  5. R. Besson
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  6. T. Perniceni
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  7. R. Costi
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  8. P. Wind
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  9. D. Fuks
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  10. B. Gayet
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Correspondence to A. Zarzavadjian Le Bian.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Zarzavadjian Le Bian, A., Denet, C., Tabchouri, N. et al. The effect of metabolic syndrome on postoperative outcomes following laparoscopic colectomy. Tech Coloproctol 22, 215–221 (2018). https://doi.org/10.1007/s10151-018-1772-7

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  • DOI: https://doi.org/10.1007/s10151-018-1772-7

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