Laparoscopic small bowel length measurement: nonassociative nature of total small bowel length with anthropometric and clinical characteristics in patients undergoing bariatric surgery

Surg Obes Relat Dis. 2024 Mar 25:S1550-7289(24)00125-4. doi: 10.1016/j.soard.2024.03.018. Online ahead of print.

Abstract

Background: Small bowel length (SBL) may have an impact on the outcomes of bariatric surgeries, but it can be difficult to make a direct association between SBL and the safety and outcome of bariatric surgeries.

Objectives: To address this issue, we set out to devise a predictive model for SBL determination based on clinical and anthropometric variables.

Setting: An academic tertiary medical center.

Methods: Anthropometric and clinical data, including age, sex, height, weight, and past medical history, were collected upon enrollment. SBL was measured twice during the surgery using a marked grasper. In all cases, measurements were carried out by a single surgeon. To create a predictive model, a 2-step approach was employed. In the first step, linear regression was used to determine influential variables. In the second step, all variables with a P value < .2 were entered into a multivariate regression model.

Results: Overall, 961 bariatric candidates were enrolled. The mean age of the participants was 40.08 years, and 77.5% (n = 745) were female. The mean SBL was 748.90 centimeters. There was a weak but statistically significant positive correlation between SBL with both weight and height. Our univariate linear model determined only anthropometric parameters as a predictor of SBL. The multivariate model also yielded that none of the entered parameters were shown to be accurate predictors of SBL. Moreover, only 4.3% of variances were explainable by this model.

Conclusion: Although we found a weak positive association between height and SBL, this association lacked clinical practicality.

Keywords: Anthropometric measures; Bariatric surgery; Clinical characteristics; Prediction model; Small bowel length.