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

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.