Measurement of visceral fat on preoperative computed tomography predicts complications after sigmoid colectomy for diverticular disease

• We aimed to identify predictors of postoperative complications in diverticulitis.
• We studied volumetric fat on preoperative CT scans and demographics were studied.
• Visceral fat was the only independent predictor of complications.
• Patients with greater than 165 cm2 visceral fat had an OR of 3.1 for developing complications.

BackgroundVisceral and subcutaneous abdominal fat parameters have been associated with worse surgical outcomes in colorectal cancer but have not been investigated in diverticulitis.MethodsVolumetric fat parameters were measured on preoperative computed tomography scans from 211 diverticulitis patients. Primary outcome was a serious postoperative complication (Clavien-Dindo grades 2-4). Variables including age, disease duration, American Society of Anesthesiology score, ostomy, immunosuppression, body mass index, and volumetric fat parameters were examined. SPSS was used for statistics.ResultsThe serious postoperative complication rate was 12.7%. On univariate analysis, several factors including older age (P = .0001), ostomy creation (P = .02), higher visceral fat (VF, P = .01), emergent surgery (P = .05), and higher American Society of Anesthesiology score (P = .05) were associated with complications. On multivariate regression analysis, only VF was independently associated with complications.ConclusionsDiverticulitis patients with high VF are more likely to develop complications after sigmoidectomy. VF measurement may potentially be used as a tool to assist in surgical decision making and prediction of outcomes.