Impact of preoperative intervention in laparoscopic sleeve gastrectomy

Abstract Background: This study aimed to investigate the impacts of calorie restriction and exercise as preoperative interventions in laparoscopic sleeve gastrectomy.Methods: Sixteen patients with obesity who underwent laparoscopic sleeve gastrectomy were enrolled, comprising 4 men and 12 women aged 33–62 years (mean age, 44.8 years). Their mean body weight and body mass index were 124.7 kg and 46.5 kg/m2, respectively. These patients underwent calorie restriction and exercise for a mean duration of 5.9 months before the surgery. The effect of this preoperative intervention on the postoperative outcome was then evaluated.Results: The patients achieved a weight loss of 8.3% (10.8 kg). The visceral fat area significantly decreased by 5.5%, whereas the skeletal muscle mass remained unaffected. Furthermore, the good-responder group (preoperative weight loss > 8%) showed a significantly higher percentage total weight loss (%TWL) at 1 year postoperatively than the poor-responder group (preoperative weight loss < 8%). In the multivariate analysis, preoperative weight loss of >8% revealed the independent factor of correlating 25% ≤ %TWL at 1 year postoperatively.Conclusions: Preoperative intervention with calorie restriction and exercise is effective for postoperative weight loss in laparoscopic sleeve gastrectomy.