Background/Aims: Higher body mass index (BMI) is associated with an increased risk of postoperative complications, but only a few studies have clarified the effect of higher BMI on perioperative outcomes in ulcerative colitis (UC). The ­purpose of this study was to evaluate the effect of higher BMI on patients undergoing surgery for UC. Methods: UC patients who underwent surgery between April 2012 and August 2015 were included. Higher BMI was defined as a BMI ≥25 kg/m2. Patients were classified as having a higher BMI or an unelevated BMI. We analyzed comparison characteristics, surgical outcomes, and pouch-related complications (PRC). Possible risk factors for PRC were also analyzed. Results: A total of 16 out of 165 (9.7%) patients had higher BMIs. The incidence of PRC in patients with higher BMIs was significantly higher than in those with unelevated BMIs. Male gender (OR 3.86, 95% CI 1.23–15.4, p = 0.02) and BMI ≥25 kg/m2 (OR 5.87, 95% CI 1.59–21.67, p < 0.01) were identified as independent risk factors for PRC. Conclusion: UC patients with higher BMIs had significantly higher incidences of PRC. Male gender and a higher BMI were identified as independent risk factors for PRC. The pouch operation as an initial surgery may be avoided in patients with higher BMIs to prevent PRC.

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