Changes in the abdominal fat distribution after gastrectomy: computed tomography assessment

Area of Science:

• Gastroenterology
• Surgical Oncology
• Radiology

Background:

• Investigating postoperative body composition changes after gastrectomy.
• Comparing visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) changes.
• Assessing fat distribution alterations following gastric cancer surgery.

Purpose of the Study:

• To quantify changes in total adipose tissue (TAT), VAT, and SAT after total gastrectomy (TG) and subtotal gastrectomy (STG).
• To compare the impact of TG versus STG on fat tissue volume.
• To evaluate the persistence of fat loss and changes in VAT/SAT ratio post-gastrectomy.

Main Methods:

• Retrospective analysis of 38 gastric cancer patients undergoing TG (n=10) or STG (n=28).
• Abdominal and pelvic CT scans performed preoperatively and at 6 and 12 months post-surgery.
• Calculation of TAT, VAT, and SAT volumes using multislice method.

Main Results:

• Significant reductions in TAT, VAT, and SAT observed in both TG and STG groups within 6 months post-surgery.
• TG group showed a further VAT reduction from 6 to 12 months; STG group exhibited VAT regain.
• The ratio of VAT to SAT decreased continuously in both groups throughout the observation period.

Conclusions:

• Gastrectomy leads to significant postoperative loss of TAT, VAT, and SAT up to 6 months.
• VAT reduction is greater and more persistent than SAT reduction, particularly after TG.
• Altered fat distribution, with a decreasing VAT/SAT ratio, is a key finding post-gastrectomy.