Michael E. DeBakey VA Medical Center - Houston, Texas

VA Study Finds Waist Circumference Predicts Complications in Rectal Cancer Surgery
April 30, 2010

According to researchers at the Michael E. DeBakey VA Medical Center, a patient’s waist circumference can serve as a predictor as to whether the patient will experience complications in recovering from rectal cancer surgery. Above, David H. Berger, M.D., M.H.C.M., co-author of the paper and MEDVAMC Operative Care Line Executive (right) performs surgery with (from left) Ronnie Blake, health technician, David Chafey, M.D., resident, and Kostas Votanopoulos, M.D., chief resident. PHOTO BY: Mike Lane, MEDVAMC Media Section

HOUSTON – According to researchers at the Michael E. DeBakey VA Medical Center (MEDVAMC) and Baylor College of Medicine (BCM), a patient’s waist circumference can serve as a predictor as to whether the patient will experience complications in recovering from rectal cancer surgery.

“Being overweight or obese is known to impact a patient’s ability to recover from surgery,” said David H. Berger, M.D., M.H.C.M., co-author of the paper, MEDVAMC Operative Care Line Executive, and professor of Surgery at BCM. “However, our study indicates abdominal fat is particularly relevant to abdominal surgical outcomes.”

Berger and Courtney Balentine, M.D., co-author of the paper, a MEDVAMC surgical resident, and a fellow in surgical research at BCM, sought to find out if a patient’s waist circumference could serve as a better indicator than body mass index (BMI) in determining whether a patient would have difficulty recovering from surgery. BMI is a common measurement that uses a person’s height and weight to formulate a measure of overweight or obesity.

“It is our contention that BMI misses the nuances of obesity because it is unable to demonstrate where the fat is distributed on the patient,” said Balentine.

The study of 150 patients who underwent rectal cancer surgery found heavier patients were twice as likely to experience complications than patients with a smaller waist circumference. Patients with a waist of 45 inches or more were three times more likely to experience surgical site infections and twice as likely to require a second operation after their initial surgery.

“This study provides important insight for surgeons planning to operate on a patient with heavy midline fat distribution,” said Berger. “Necessary surgical procedures cannot be avoided, but surgeons may want to consider altering antibiotic dosages in order to better fight infection.”

Past studies of BMI and surgical infections have had inconsistent findings. Berger and Ballentine’s study is the first using waist circumference as a predictor of short-term surgical complications.