Clinical value of visceral fat area combined with sex in predicting operative time of laparoscopic Roux-en-Y gastric bypass

ZENG Song-hua; HUANG Hong-yan; WANG Lei; WU Hui; WU Liang-ping

doi:10.13820/j.cnki.gdyx.20252284

Abstract：Objective To investigate the predictive value of visceral fat area(VFA)for operative time in laparo-scopic Roux-en-Y gastric bypass(LRYGB)and to evaluate whether combining VFA with sex improves prediction accu-racy,thereby providing evidence for optimized surgical planning in obese patients with type 2 diabetes mellitus(T2 DM).Methods Clinical data of 47 obese patients with T2DM(BMI ≥27.5 kg/m2)undergoing LRYGB were retrospectively analyzed.Preoperative VFA and related body composition parameters were measured using a bioelectrical impedance ana-lyzer(InBody 230).Operative time and perioperative complications were recorded.Fifteen non-obese T2DM patients(BMI＜27.5 kg/m2)served as controls.Spearman correlation analysis was performed to assess the relationship between VFA and operative time.Multivariate linear regression was used to identify independent influencing factors.Receiver oper-ating characteristic(ROC)curves were constructed to evaluate the predictive performance of VFA alone and in combina-tion with sex.Results VFA was significantly higher in the obese group than in the control group(P＜0.05),and female patients had a higher VFA than male patients[(131.07±34.44)cm2 vs.(112.79±15.44)cm2,P=0.029].Opera-tive time was positively correlated with VFA(r=0.443,P＜0.01).Multivariate linear regression analysis identified VFA as an independent predictor of operative time(P＜0.05).The area under the ROC curve(AUC)for VFA alone in pre-dicting prolonged operative time was 0.689(95％CI:0.538-0.840),with a sensitivity of 91.67％and a specificity of 39.13％.When combined with sex,the AUC increased to 0.808(95％CI:0.684-0.932),with a sensitivity of 66.67％and a specificity of 82.67％.Conclusion Visceral fat area is an independent predictor of operative time in LRYGB.Combining VFA with sex significantly improves predictive accuracy.Incorporating preoperative VFA assessment,particularly in female patients,into risk stratification may facilitate better surgical resource allocation and optimization of clinical pathways.