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Obesity Surgery

, Volume 28, Issue 8, pp 2379–2385 | Cite as

Preoperative Detection of Sarcopenic Obesity Helps to Predict the Occurrence of Gastric Leak After Sleeve Gastrectomy

  • Martin Gaillard
  • Hadrien TranchartEmail author
  • Sophie Maitre
  • Gabriel Perlemuter
  • Panagiotis Lainas
  • Ibrahim Dagher
Original Contributions

Abstract

Background

Sleeve gastrectomy (SG) has become the primary procedure for many bariatric teams and staple-line leak represents its most feared complication. Sarcopenic obesity combines the risks of obesity and depleted lean mass leading possibly to an inferior surgical outcome after abdominal surgery.

Objectives

The aim of this study was to evaluate the existence of a potential link between radiologically determined sarcopenic obesity and staple-line leak risk after SG.

Methods

A retrospective analysis of a prospective database was performed in consecutive patients undergoing SG as primary procedure. Total psoas muscles (TPA) and total visible muscles (TMA) areas were measured on a preoperative computed tomography (CT). Sarcopenia was defined as lowest tertile of skeletal muscular mass indexes (muscular areas over square of height) in each gender (using TPA or TMA). Multivariate analysis was performed to determine preoperative risk factors for staple-line leak.

Results

During the study period, 205 patients were included in the analysis. Median BMI was 40.8 kg/m2 (34.2–49.6), and 9 patients (4.4%) presented a gastric leak. The sex-specific cut-offs for skeletal muscular mass index according to TPA were 8.2 cm2/m2 for men and 6.08 cm2/m2 for women. After multivariate analysis, preoperative weight (OR = 1043) and sarcopenia (TPA) (OR = 5204) were independent predictive factors for gastric leak.

Conclusions

The present series suggests that CT scan-determined sarcopenic obesity is associated with increased risk of gastric leak after SG. This preoperatively radiological examination would be a useful clinical tool to tailor patient management according to gastric leak risk.

Keywords

Sarcopenia Obesity Gastric leak Sleeve gastrectomy Tomodensitometry 

Notes

Compliance with Ethical Standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Minimally Invasive Digestive SurgeryAntoine Béclère Hospital, AP-HPClamartFrance
  2. 2.Paris-Sud UniversityOrsayFrance
  3. 3.Department of RadiologyAntoine Béclère Hospital, AP-HPClamartFrance
  4. 4.Department of Hepato-Gastroenterology and NutritionAntoine Béclère Hospital, AP-HPClamartFrance

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