Clinical Impact of Body Fat Accumulation on Postoperative Complications Following Laparoscopic Low Anterior Resection for Rectal Cancer

Abnormal body fat accumulation has become an important global health problem. The present study investigated the impact of body fat accumulation on postoperative complications following laparoscopic low anterior resection for rectal cancer. A case series analysis was conducted for 121 patients who underwent laparoscopic low anterior resection for rectal cancer. Abnormal body fat accumulation, defined as a body mass index (BMI) of ≥ 25 kg/m² and visceral fat area (VFA) > 100 cm², was noted in 24.0% (29/121) and 38.0% (46/121) of subjects, respectively. The high-VFA group included a larger number of subjects with a high American Society of Anesthesiologists physical status than the low-VFA group (P = 0.022). Hypertension was significantly more frequent in the high-BMI group (P = 0.009) and high-VFA group (P = 0.008) than in other groups. The operative time and intraoperative bleeding amount were significantly longer and larger, respectively, in the high-BMI group (P = 0.005 and P = 0.023) and high-VFA group (P < 0.001 and P = 0.002) than in other groups. The number of cartridges for rectal transaction tended to be particularly increased in the high-BMI and high-VFA groups (P = 0.028 and P = 0.006, respectively). Regarding postoperative complications, there were no significant differences in the incidence of total complications or severe complications regardless of the BMI or VFA. The postoperative hospital stay was also significantly longer in the high-BMI group than in the other groups (P = 0.023). The presence of abnormal body fat accumulation might result in a lengthy operation time and greater intraoperative blood loss. However, its influence on the postoperative course and postoperative complications might be relatively non-impactful in cases of laparoscopic low anterior resection among patients with rectal cancer.