To investigate the predictive value of visceral adipose for early major complications after rectal cancer surgery by CT scan.

A retrospective case-control study method was used to recruit a total of 135 patients with rectal cancer who underwent radical resection at Beijing Friendship Hospital, Capital Medical University from January 2017 to June 2018. There were 89 males and 46 females, aged from 30 to 88 years, with a median age of 63 years. The patients were divided into complication group (n=16) and control group (n=119) according to whether serious complications occurred within 30 days after operation. Measurement data with normal distribution were expressed as Mean±SD, and comparison between groups was analyzed by using independent sample t-test. Measurement data with skewed distribution were represented as M (Q₁, Q₃) and analyzed by using the Mann-Whitney U test. Count data were expressed as constituent ratio, and analyzed using the chi-square test or Fisher exact test. Logistic regression model was used to analyze the factors affecting the occurrence of early severe complications after radical resection of rectal cancer. The area under the receiver operating characteristic (ROC) curve (AUC) was used to analyze the predictive ability of the model for early severe complications after radical resection of rectal cancer.

Univariate analysis showed that there were significant differences in intraoperative blood loss [100 (62, 187) mL vs 50 (40, 100) mL, Z=-2.038, P=0.042], operation time [(325 (212, 375) min vs 260 (180, 310) min, Z=-2.04, P=0.041)], preoperative blood glucose [4.67 (4.44, 5.09) mmol/L vs 5.20 (4.80, 5.72) mmol/L, Z=-3.33, P=0.001] and visceral fat area/subcutaneous fat area (V/S) (1.23±0.54 vs 0.96±0.40, t=-2.39, P=0.018) between the complication group and the control group. Multivariate Logistic regression model showed that V/S ratio (OR=3.978, 95%CI: 1.160-13.636, P=0.028) and preoperative blood glucose level (OR=0.168, 95%CI: 0.055-0.512, P=0.002) were independent risk factors for early major complications after radical resection of rectal cancer.

Visceral fat and preoperative blood glucose level are independent risk factors for early major complications after radical resection of rectal cancer, V/S is expected to be a predictor of early major complications after radical resection of rectal cancer.

Rectal neoplasms; Obesity; Postoperative complications; Visceral Adipose