Correlation of Short-term Weight Loss after Laparoscopic Sleeve Gastrectomy and Visceral Adipose Tissue Distribution in Patients with Moderate to Severe Obesity

  Objective   This study aimed to investigate the short-term weight loss after laparoscopic sleeve gastrectomy and its correlation with visceral adipose tissue distribution in patients with moderate to severe obesity.

  Methods   The clinical information of moderately to severely simple obesity patients who underwent laparoscopic sleeve gastrectomy in Peking Union Medical College Hospital from November 2015 to August 2017 was retrospectively analyzed, including age, gender, height, body weight, and abdominal CT images within one week before the operation. The visceral adipose tissue area, total adipose tissue area, and visceral adipose tissue ratio weredetermined by a Siemens post-processing workstation. The body weight of the patients was followed up at 1, 3, and 6 months after surgery; the percentage of total weight loss (%TWL) and the percentage of excess weight loss (%EWL) were calculated.

  Results   A total of 20 patients who met the inclusive and exclusive criteria were enrolled in this study, 2 men and 18 women, with an average age of (28.2±6.6) years old. Their preoperative weight was (118.5±20.9)kg, body mass index (BMI) was (41.3±7.8)kg/m². At the umbilical plane level, the visceral adipose tissue, the subcutaneous adipose tissue, the total adipose tissue, and the visceral adipose tissue ratio were (196.1±49.3)cm², (738.2±152.7)cm², (934.3±169.7)cm², and (21.1±4.6)%. At 1, 3, and 6 months after laparoscopic sleeve gastrectomy, the body weights were (105.4±19.7)kg, (96.0±19.8)kg, and (88.3±17.5)kg; BMIs were (37.1±7.4)kg/m², (33.8±7.6)kg/m², and (31.1±6.6)kg/m²; %EWLs were (29.3±9.7)%, (50.0±14.8)%, and (65.3±18.1)%, respectively; all these criteria showed a continuously downward trend. The proportions of successful weight loss (%EWL >50%) at 1, 3, and 6 months after surgery were 0, 55%, and 70%, respectively.%EWL was negatively correlated with the preoperative weight (R=-0.604, P=0.005), BMI (R=-0.621, P=0.005), total adipose tissue (R=-0.686, P=0.001), and positively corrected with the ratio of visceral adipose tissue (R=0.504, P=0.024).

  Conclusions   Short-term weight loss after laproscopic sleeve gastrectomy is obvious. Low preoperative body weight, low BMI, and high visceral adipose tissue may be the predictors for effective weight loss after laparoscopic sleeve gastrectomy.