A preliminary study of the relationship between intra-abdominal fat and postoperative complications of Crohn′s disease

Objective To explore the effects of intra-abdominal fat (IAF) on postoperative complications of Crohn′s disease (CD) . Methods Clinical data of 50 CD patients undergoing abdominal surgery at the Department of General Surgery, Tianjin Medical University General Hospital from May 2008 to April 2017 were retrospectively analyzed. Meanwhile the CT images of these patients were collected. Image J software was used to measure the IAF of patients before surgery. These patients were divided into with postoperative complication group (16 cases) and without postoperative complication group (34 cases) and clinical characters of these two groups were compared. The risk factors of postoperative complication were analyzed by Logistic regression. Results Of 50 CD patients, 16 developed postoperative complications and the morbidity was 32.0%. As compared to without postoperative complication group, with postoperative complication group had longer disease course[ (6.9 ±5.0) years vs. (3.0 ±2.7) years, P = 0.008], higher ratio of preoperative emergent complication (81.3% vs. 52.9%, P = 0.040) , lower serum albumin level [ (29.8 ±4.2) g/L vs. (34.2 ±6.5) g/L, P = 0.007], less area of IAF[ (3044.6 ±1125.4) vs. (4271.5 ±1830.6) , P = 0.006] and higher ratio of intestinal non-side-to-side anastomosis (56.2% vs 20.6%, P = 0.021) . Multivariate Logistic regression analysis showed that IAF less than 3000 (OR: 9.743, 95% CI: 1.508 to 62.943) , non-side-to-side anastomosis (OR: 6.843, 95%CI: 1.126 to 41.572) and emergent operation (OR: 6.981, 95% CI: 1.086 to 44.876) were independent risk factors of postoperative complications of CD. Conclusion IAF is an independent risk factor of postoperative complication of CD, suggesting that the IAF can be used as an evaluation index for postoperative complications. Key words: Intra-abdominal fat; Crohn′s disease; Surgery; Complication