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

Abstract Background 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 pr...

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Main Authors: Islam Haney Shawali, Yara ELhefnawi, Mohammed ElShwadfy Nageeb, Bahaa Eldin Mahmoud
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Gastroenterology
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Online Access:https://doi.org/10.1186/s12876-025-04176-4
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Summary:Abstract Background 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. Methods 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. Results 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. Conclusion 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.
ISSN:1471-230X