Introduction
Hospitalization and surgical
procedures affect normal homeostasis and trigger metabolic stress
response. This process is commonly called Systemic Inflammatory Response
or Surgical Stress Response (SSR), and involves both immune and
neuro-endocrine systems 1.
Several approaches have been proposed for assaying SSR in clinical
practice, with C-reactive protein (CRP) measurement remaining the most
used and affordable strategy. In colorectal surgery several studies
confirmed the usefulness of CRP for safe early discharge, aiming at
early detection of adverse events 2. Conversely,
several procedure- and patient-related factors could influence SSR, so
that specific subgroups of patients may need the estimation and
application of specific cut-off values. Among these factors, surgical
approach and nutritional status have been recently found to be
associated with SSR 3–5. In particular, low skeletal
muscle mass has been associated with increased SSR 4,
whilst little is known on the post-operative pro-inflammatory role of
visceral obesity (VO) and its possible clinical implications.
In this study, we assessed the relationship between visceral adipose
tissue (VAT) area measured at CT scan and SSR defined according to
peri-operative CRP levels. We assumed that VO, defined as VAT excess,
could intensify SSR following laparoscopic colorectal surgery, thus
requiring specific cut-off values for detecting post-operative
infectious complications in VO patients.