TY - JOUR
T1 - Low-calorie diets are effective for weight loss in patients undergoing benign upper gastrointestinal surgery
T2 - a systematic review and meta-analysis
AU - Chowdhury, Nibir
AU - Hasnan, Syarafina
AU - Ullah, Shahid
AU - Thompson, Sarah K.
PY - 2024/8
Y1 - 2024/8
N2 - Background: Obesity may increase surgical complexity in patients undergoing abdominal surgery by limiting visualization and increasing the risk of peri-operative complications. A preoperative reduction in weight and liver volume may improve surgical outcomes. The aim of our study was to evaluate the efficacy of a low-calorie diet (LCD) versus a very low-calorie diet (VLCD) in reducing weight and liver volume prior to laparoscopic surgery. Methods: A systematic search was conducted using the following inclusion criteria: obese patients undergoing preoperative weight loss using a VLCD or LCD, evaluation of liver volume reduction, and the use of an imaging modality before and after the diet. Results: A total of 814 patients from 21 different studies were included in this systematic review and meta-analysis, with 544 female patients (66.8%) and a mean age range between 24 and 54 years old. There was a total mean weight loss of 6.42% and mean liver volume reduction of 16.7%. Meta-analysis demonstrated that a preoperative diet (LCD or VLCD) significantly reduced weight [SMD = − 0.68; 95% CI (− 0.93, − 0.42), I2 = 82%, p ≤ 0.01] and liver volume [SMD = − 2.03; 95% CI (− 4.00, − 0.06), I2 = 94%, p ≤ 0.01]. When assessed individually, a VLCD led to significant weight reduction [SMD = − 0.79; CI (− 1.24; − 0.34), p ≤ 0.01, I2 = 90%], as did an LCD [SMD = − 0.60; CI (− 0.90; − 0.29), p ≤ 0.01, I2 = 68%). Similarly, there was a significant reduction in liver volume following a VLCD [SMD = − 1.40; CI (− 2.77, − 0.03), p ≤ 0.01, I2 = 96%], and an LCD [SMD = − 2.66; CI (− 6.13, 0.81), p ≤ 0.01, I2 = 93%]. However, there was no significant difference between the two regimens. Conclusions: Preoperative restrictive calorie diets are effective in reducing weight and liver volume prior to laparoscopic surgery. Whilst a VLCD was better than an LCD at reducing both weight and liver volume, the difference was not significant. Graphical abstract: (Figure presented.)
AB - Background: Obesity may increase surgical complexity in patients undergoing abdominal surgery by limiting visualization and increasing the risk of peri-operative complications. A preoperative reduction in weight and liver volume may improve surgical outcomes. The aim of our study was to evaluate the efficacy of a low-calorie diet (LCD) versus a very low-calorie diet (VLCD) in reducing weight and liver volume prior to laparoscopic surgery. Methods: A systematic search was conducted using the following inclusion criteria: obese patients undergoing preoperative weight loss using a VLCD or LCD, evaluation of liver volume reduction, and the use of an imaging modality before and after the diet. Results: A total of 814 patients from 21 different studies were included in this systematic review and meta-analysis, with 544 female patients (66.8%) and a mean age range between 24 and 54 years old. There was a total mean weight loss of 6.42% and mean liver volume reduction of 16.7%. Meta-analysis demonstrated that a preoperative diet (LCD or VLCD) significantly reduced weight [SMD = − 0.68; 95% CI (− 0.93, − 0.42), I2 = 82%, p ≤ 0.01] and liver volume [SMD = − 2.03; 95% CI (− 4.00, − 0.06), I2 = 94%, p ≤ 0.01]. When assessed individually, a VLCD led to significant weight reduction [SMD = − 0.79; CI (− 1.24; − 0.34), p ≤ 0.01, I2 = 90%], as did an LCD [SMD = − 0.60; CI (− 0.90; − 0.29), p ≤ 0.01, I2 = 68%). Similarly, there was a significant reduction in liver volume following a VLCD [SMD = − 1.40; CI (− 2.77, − 0.03), p ≤ 0.01, I2 = 96%], and an LCD [SMD = − 2.66; CI (− 6.13, 0.81), p ≤ 0.01, I2 = 93%]. However, there was no significant difference between the two regimens. Conclusions: Preoperative restrictive calorie diets are effective in reducing weight and liver volume prior to laparoscopic surgery. Whilst a VLCD was better than an LCD at reducing both weight and liver volume, the difference was not significant. Graphical abstract: (Figure presented.)
KW - Bariatric surgery
KW - Liver volume
KW - Low-calorie diet
KW - Very low-calorie diet
KW - Weight loss
UR - http://www.scopus.com/inward/record.url?scp=85197773897&partnerID=8YFLogxK
U2 - 10.1007/s00464-024-11016-1
DO - 10.1007/s00464-024-11016-1
M3 - Review article
AN - SCOPUS:85197773897
SN - 0930-2794
VL - 38
SP - 4171
EP - 4185
JO - Surgical Endoscopy
JF - Surgical Endoscopy
IS - 8
ER -
