The prediction of the risk of developing complications after colorectal surgery for colorectal carcinoma remains imprecise. Body composition measurements on a computed tomography (CT) scan can potentially contribute to a better preoperative risk assessment. The aim of this systematic review is to evaluate the evidence for the use of body composition measurements on CT scans to predict short‐term complications after colorectal cancer surgery. A literature search (in PubMed, Embase and Web of Science) was performed up to 1 August 2022. Two researchers independently screened the articles, extracted data and assessed the quality of the studies using the Quality in Prognosis Studies tool. The primary outcome measure was the occurrence of complications within 30 days after surgery. Meta‐analysis was conducted using a random‐effects model to synthesize a pooled odds ratio (OR). The study protocol was registered in PROSPERO (CRD42021281010). Forty‐five articles with a total of 16 537 patients were included. In total, 26 body composition measures were investigated: 8 muscle‐related measures, 11 adipose tissue measures, 4 combined muscle and adipose tissue measures, and 3 other measures. These were investigated as potential predictors for more than 50 differently defined postoperative complications. Meta‐analysis was only possible for two measurements and showed that higher amounts of visceral fat increase the risk of developing overall complications (OR: 2.52 [1.58–4.00], P < 0.0001) and anastomotic leakage (OR: 1.76 [1.17–2.65], P = 0.006). A wide variety of body composition measurements on preoperative CT scans have been investigated as a predictive factor for postoperative complications. Visceral fat appeared to be associated with overall complications and anastomotic leakage; however, the association is weak, and its clinical relevance or applicability is questionable. The current evidence is limited by methodological heterogeneity and the risk of bias. To improve comparability of results across studies and improve decision‐making, future studies should use standardized methods for measuring body composition on CT scans, outcome definitions and statistical analyses.

中文翻译：

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计算机断层扫描衍生的身体成分与结直肠癌手术后并发症的关联： 系统评价和荟萃分析


对结直肠癌结直肠手术后发生并发症风险的预测仍然不精确。计算机断层扫描 （CT） 扫描的体成分测量可能有助于更好的术前风险评估。本系统综述的目的是评估在 CT 扫描中使用身体成分测量来预测结直肠癌手术后短期并发症的证据。截至 2022 年 8 月 1 日进行了文献检索（在 PubMed、Embase 和 Web of Science 中）。两名研究人员使用 Quality in Prognosis Studies 工具独立筛选文章、提取资料并评估研究质量。主要结局指标是术后 30 天内并发症的发生率。使用随机效应模型进行荟萃分析，以合成合并比值比 （OR）。该研究方案在 PROSPERO （CRD42021281010） 中注册。共纳入 45 篇文章，共 16 537 例患者。总共调查了 26 项身体成分测量： 8 项肌肉相关测量、11 项脂肪组织测量、4 项肌肉和脂肪组织联合测量以及 3 项其他测量。这些被调查为 50 多种不同定义的术后并发症的潜在预测因子。荟萃分析只能进行两次测量，结果显示，内脏脂肪含量较高会增加发生总体并发症 （OR： 2.52 [1.58–4.00]，P < 0.0001） 和吻合口瘘 （OR： 1.76 [1.17–2.65]，P = 0.006） 的风险。术前 CT 扫描中的各种身体成分测量已被研究为术后并发症的预测因素。 内脏脂肪似乎与整体并发症和吻合口瘘有关;然而，这种关联很弱，其临床相关性或适用性值得怀疑。目前的证据受到方法学异质性和偏倚风险的限制。为了提高研究结果的可比性并改善决策，未来的研究应使用标准化方法来测量 CT 扫描中的身体成分、结果定义和统计分析。