Application value of quantitative computed tomography for evaluation of changes in abdominal fat after laparoscopic Roux-en-Y gastric bypass in obese patients / 中华消化外科杂志

ABSTRACT

Objective To evaluate the application value of quantitative computed tomography for evaluation of changes in abdominal fat after laparoscopic Roux-en-Y gastric bypass in obese patients.Methods The retrospective and descriptive study was conducted.The clinical data of 52 obese patients who underwent laparoscopic Roux-en-Y gastric bypass in the Third Medical Center of Chinese PLA General Hospital from March 2011 to February 2012 were collected.There were 24 males and 28 females,aged (43±9)years,with the range of 23-62 years.All the 52 patients underwent laparoscopic Roux-en-Y gastric bypass.Observation indicators:(1) surgical and postoperative conditions;(2) changes in anthropometric indices;(3) follow-up.Follow-up using outpatient examination was performed to detect complications of patients at 1,3,6,12 months after surgery up to February 2013.Measurement data with normal distribution were represented as Mean±SD,repeated measurement data were analyzed using repeated ANOVA.Count data were represented as absolute numbers.Results (1) Surgical and postoperative conditions:all the patients underwent laparoscopic Roux-en-Y gastric bypass successfully,without conversion to open surgery.The volume of intraoperative blood loss,operation time,and duration of hospital stay were (25± 11) mL,(78± 14) minutes,and (11±2) days.(2) Changes in anthropometric indices:the body mass index (BMI),fat mass,free fat mass,total abdominal fat volume (TAFV),total subcutaneous fat volume (TSFV),and total visceral fat volume (TVFV) of all the 52 patients were (31.8 ± 1.8)kg/m2,(39.4±4.1)kg,(50.2±6.0)kg,(l1 703±3 899)cm3,(7 418±2 969)cm3,and (4 314± 1 692)cm3 before surgery,(28.5±1.4)kg/m2,(33.0±1.1)kg,(49.7±4.6)kg,(11 016±3 713) cm3,(7 044± 2970)cm3,(3969±1 443)cm3 at 3 months after surgery,(27.1±1.7)kg/m2,(30.2±1.3)kg,(45.4± 3.1)kg,(9 406±4 452)cm3,(6 442±3 307)cm3,and (2 964±1 694) cm3 at 6 months after surgery,(24.4± 2.4)kg/m2,(32.6±1.1)kg,(48.6±2.7)kg,(7 612±3 029)cm3,(5 623±2 650)cm3,and (1 826±360) cm3 at 12 months after surgery,respectively,there were significant differences in the changes of these indices (F=130.2,30.3,4.9,25.6,11.9,16.5,P＜0.05).The BMI,fat mass,and TAFV at 3 months after surgery had significant differences compared with those before surgery (P＜0.05),but free fat mass,TSFV,and TVFV had no significant difference (P＞0.05).The BMI,fat mass,TAFV,and TVFV at 6 months after surgery had significant differences compared with those before surgery (P ＜ 0.05),but free fat mass and TSFV had no significant difference (P＞0.05).The BMI,fat mass,TAFV,TSFV,and TVFV at 12 months after surgery had significant differences compared with those before surgery (P＜0.05),but free fat mass had no significant difference (P＞ 0.05).(3) Follow-up:all the 52 patients have completed the follow-up after surgery and the remission number of obesity was 35.No complications such as anastomotic hemorrhage,obstruction,or anastomotic leakage occured in all the 52 patients.Conclusion Laparoscopic Roux-en-Y gastric bypass can reduce abdominal visceral fat significantly,while quantitative computed tomography can help to evaluate the distribution of abdominal visceral fat accurately.