Hideya Kashihara, Mitsuo Shimada, Kozo Yoshikawa, Jun Higashijima, Tomohiko Miyatani, Takuya Tokunaga, Masaaki Nishi, Chie Takasu. Department of surgery, Tokushima university
Background: Our department perform preoperative weight loss program for the purpose of decreasing the perioperative complication in sleeve gastrectomy (SG). The aim of this study is to show the surgical outcome of SG and predictive marker of postoperative weight loss.
Patients and Methods:
1. 13 obese patients who underwent SG were enrolled in the preoperative weight loss program (Duration; 37.2days). Preoperative weight loss program contains calorie restriction (1200kcal/day) and exercise by the nutrition support team.
2. The relationship between % EWL in postoperative 1 year and preoperative neutrophil/ lymphocyte ratio (NLR) was examined in the cases with less postoperative weight loss after SG.
1.The preoperative weight loss program showed decrease of body weight (-12.1kg, -9.1%), visceral fat mass (230.9→192.9), improvement of transaminase and maintenance of skeletal muscle. There was no perioperative complication. %EWL in 3, 6 months and 1 year were 46.3, 50.8 and 47.4%. In postoperation, SG improved NASH (AST/ ALT, FIB4 index, liver to spleen ratio in CT value). Obesity related disease were improved (diabetes; 75%, hypertension; 64%, hyperlipidemia; 71%, SAS; 90%). NLR in postoperative 3 months showed decrease (2.68→1.86). So, immune function was improved.
2. There was negative relationship between preoperative NLR and %EWL in postoperative 1 year (R2=0.52). Comparing preoperative NLR in %EWL<50% and ?50% in postoperative 1 year, <50% was 2.97 and ?50% was 2.01 (cut-off 2.25). Preoperative NLR predicts postoperative weight loss in SG.
Conclusion: Preoperative weight loss program is effective in SG. However, more strong preoperative intervention or bypass surgery may be needed in the cases with NLR?2.25.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94053
Program Number: P057
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster