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

We investigated the postoperative changes in visceral fat, as compared with subcutaneous fat in patients who underwent total gastrectomy (TG) or subtotal gastrectomy (STG).

Thirty-eight patients of gastric cancer who underwent abdominal and pelvic computed tomography scans before and after STG (n = 28) or TG (n = 10) were examined. The volumes of the total, visceral and subcutaneous adipose tissues (TAT, VAT and SAT, respectively) were calculated in each scan using the multislice method. Changes between the preoperative data and results obtained at 6 and 12 months after surgery were evaluated.

In the first 6 months, there were significant decreases in TAT, VAT and SAT values in the TG (-2424 +/- 1309, -1535 +/- 1056 and -889 +/- 613 cm(3), respectively) and STG (-1590 +/- 1309, -1024 +/- 645, and -578 +/- 659 cm(3), respectively) groups. From 6 to 12 months after surgery, a further significant reduction in VAT (-351 +/- 196 cm(3)) in the TG group and significant regains in TAT and SAT (850 +/- 1205 and 757 +/- 1032 cm(3), respectively) in the STG group were observed. The ratio of VAT to SAT calculated in both groups decreased continuously in all periods of observation.

Patients who underwent gastrectomy lost TAT, VAT and SAT during the postoperative period up to 6 months and the decrease in VAT was greater and more persistent than the decrease in SAT, particularly in the TG group.