CT assessment of total abdominal muscle area index (TAMAI) as a predictive tool for early post operative complications in laparoscopic sleeve gastrectomy: a prospective case-control study

TL;DR

This study shows that measuring abdominal muscle area via CT scans can predict early complications after weight loss surgery.

Contribution

The study introduces TAMAI as a novel CT-based predictor of postoperative complications in bariatric surgery.

Findings

TAMA and TAMAI were significantly associated with early post-operative complications in LSG patients.

Non-contrast CT scans at the L3 level effectively measured sarcopenia markers for complication prediction.

Abstract

In metabolic bariatric surgery (MBS) a lot of focus is made on preoperative risk assessment to enhance patient’s baseline performance and improve postoperative clinical outcomes. The aim of this study is to assess pre-operative sarcopenia by computed tomography (CT) scan, as a predictive tool for early post-operative complications in candidates for MBS.

This is a single center prospective case-control study. The study includes using non-contrast CT cuts at L3 vertebra level to measure total abdominal muscle area (TAMA) and visceral fat area (VFA). TAMA was indexed to the patient height and VFA/TAMAI ratio was estimated. Models for predicting postoperative complications were made for TAMA alone, TAMAI alone, VFA alone and VFA/TAMAI ratio to assess each factor’s reliability in predicting postoperative complications.

The study enrolled 30 patients who underwent laparoscopic sleeve gastrectomy (LSG); 14 experience early post-operative complications in the cases arm, matched against 16 in the control arm. TAMA and TAMAI showed a significant association with early post-operative complications.

Our findings suggest that TAMA and TAMAI, measured by non-contrast CT as markers for sarcopenia, may be associated with early post-operative complications for laparoscopic sleeve gastrectomy (LSG) patients.

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