Correlation Between the Total Small Bowel Length and Anthropometric Measures in Living Humans: Cross-Sectional Study

Mohamed Bekheit* (Corresponding Author), Mohamed Y. Ibrahim, Wael Tobar, Ibrahim Galal, Athar S. Elward

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Background
Variation in the outcome of bariatric surgery is still an unraveled phenomenon. This variation could be multifactorial. Several reports implicate the total small bowel length (TSBL) in this process. However, the basic information regarding the normal bowel length and its relation to the anthropometric parameters of the living subject is scarce. This study aims at reporting the normal total bowel length in living adult humans and its correlation with the anthropometric parameters.

Methods
This study included 606 participants (380 females and 226 males). Their mean age was 39.8 ± 11 years, weight = 135.7 ± 29.7 kg, height = 165 ± 9 cm, and BMI = 49.5 ± 7.5 kg/m2.

The mean TSBL was 630 ± 175 cm. There was a statistically significant but very weak positive correlation but between the TSBL and both weight and height.

Males had significantly higher weight and were significantly taller compared with females. TSBL was significantly longer in males at 661.5 ± 186 cm versus 612 ± 164 cm in females.

Conclusion
The study reports an average TSBL greater than what is reported in the literature from living humans with a greater range of variation. There is no clinically important correlation between the TSBL and the weight and height of the individual participants in this series.

Keywords
Small bowel Total bowel length BMI Height Weight
Background
Morbid obesity is a global challenge that has attracted the attention of the healthcare providers over the decades [1]. Many options are currently available for the treatment of morbid obesity [2, 3]. The surgical treatment represents the most effective and probably the most durable solution [4]. The surgical armamentarium is equipped with several techniques [5]. Restrictive procedures are less successful on the long term compared with diversional procedures [6].

Weight regain and inadequate weight loss are among the major challenges after most of the bariatric surgeries. Furthermore, weight loss after the same procedure varies considerably among patients [7]. One of the possible explanatory factors to this phenomenon could be the variation in the length of the bypassed and/or the common bowel segments.

The precise importance of the impact of the total small bowel length (TSBL) on bariatric surgery remains elusive [8]. However, the TSBL could be an influential factor on the weight loss after bariatric surgery [9]. It was reported that different lengths of bypassed segments might influence the weight loss after RYGBP [10].

The reported TSBL in the literature was predominantly measured in deceased persons or during necropsies [11, 12, 13]. In vivo measurements were shown to be different from the measures obtained from cadaveric studies [14]. Prediction of the TSBL could be useful to avoid intraoperative measurements, which might consume extra time particularly in laparoscopic procedures in morbidly obese individuals. A CT scan–based prediction method has been proposed in the literature but without validation [15]. There is significant controversy on the role of anthropometry as predictive parameters to the TSBL [8, 16]. Therefore, the present study aims at measuring the TSBL in relation to the weight, height, and BMI of living adults.
Original languageEnglish
JournalObesity Surgery
Early online date5 Nov 2019
DOIs
Publication statusE-pub ahead of print - 5 Nov 2019

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Keywords

  • small bowel
  • total bowel length
  • BMI
  • weight
  • height
  • GASTRIC BYPASS
  • Total bowel length
  • Small bowel
  • INTESTINAL LENGTH
  • Height
  • Weight

ASJC Scopus subject areas

  • Nutrition and Dietetics
  • Surgery
  • Endocrinology, Diabetes and Metabolism

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