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TOPLINE:

In patients with Crohn's disease (CD) who underwent ileocolic resection (ICR), preoperative myosteatosis (high lipid content in skeletal muscles) was associated with postoperative complications; low subcutaneous adipose tissue levels preoperatively were protective against postoperative complications.

METHODOLOGY:

• Researchers identified 227 patients (median age at surgery, 35.1 years; 40.5% men) with CD who underwent ICR from an ongoing prospective study across eight academic and seven non-academic Dutch hospitals (March 2017 to July 2023) to assess the link between different preoperative body composition parameters and postoperative complications.
• They analysed preoperative body composition using scans from abdominal imaging performed within 12 months before surgery and examined skeletal muscle mass and subcutaneous and visceral adipose tissue at the third lumbar vertebra (L3).
• The primary outcome was the occurrence of complications within 30 days after the ICR, graded using the Clavien-Dindo classification.
• Secondary outcomes were moderate-to-severe postoperative complications, infectious postoperative complications, and endoscopic postoperative recurrence (ePOR) at 6 months after the ICR.

TAKEAWAY:

• Overall, 46.3% of patients experienced at least one postoperative complication within 30 days following the ICR, with 38.3% reporting moderate-to-severe postoperative complications and 26.0% reporting infectious postoperative complications.
• Preoperative myosteatosis was associated with postoperative complications (adjusted odds ratio [aOR], 3.09; 95% CI, 1.36-7.00), moderate-to-severe postoperative complications (aOR, 2.66; 95% CI, 1.24-5.68), and infectious postoperative complications (aOR, 2.44; 95% CI, 1.10-5.40).
• A low preoperative subcutaneous adipose tissue L3 index demonstrated protective effects against postoperative complications (aOR, 0.38; 95% CI, 0.16-0.88), whereas both low and high preoperative skeletal muscle L3 indices were linked to an increased risk for ePOR (aOR, 4.46; 95% CI, 1.09-19.57 and aOR, 2.45; 95% CI, 1.06-5.65, respectively).
• A low preoperative lipid content in visceral adipose tissue increased the risk for infectious postoperative complications (aOR, 4.31; 95% CI, 1.11-16.71), whereas a high preoperative lipid content in visceral adipose tissue provided protection against ePOR (aOR, 0.26; 95% CI, 0.07-0.99). No association was found between preoperative BMI and postoperative complications.

IN PRACTICE:

"Our study highlights the value of preoperative body composition assessment in predicting postoperative outcomes in CD patients, while BMI alone does not adequately reflect body composition nor predicts outcomes," the authors of the study wrote.

SOURCE:

This study, led by Michiel T.J. Bak, MD, and Annemarie C. de Vries MD, PhD, Department of Gastroenterology and Hepatology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands, and Karlijn Demers, MD, and Laurents P.S. Stassen, MD, PhD, Maastricht University, Maastricht, the Netherlands. It was published online on July 28, 2025, in Clinical Gastroenterology and Hepatology.

LIMITATIONS:

Heterogeneity in imaging methods and techniques existed across participating centres. Researchers could not incorporate inflammatory and nutritional markers that might have affected body composition and postoperative outcomes. The analysis was done by a single researcher, which may have introduced measurement bias.

DISCLOSURES:

This study did not receive any specific funding. Several authors reported receiving grants, non-financial support, and payment for lectures and presentations; serving as consultants, speakers, and principal investigators; and serving on the advisory boards of various pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.