Effective and safe reduction in visceral fat using a formula diet in a short period before highly invasive endoscopic surgery - Case series

Introduction: We retrospectively assessed the efficacy and safety of use of short-term formula diet therapy to achieve preoperative reduction in visceral fat immediately prior to highly invasive endoscopic surgery.

Presentation of case: We reviewed 5 cancer patients who underwent thoracoscopic and/or laparoscopic-assisted esophagectomy or gastrectomy. The cases were those with a BMI ≥30 kg/m² or waist circumference ≥100 cm. Patients replaced one meal out of the three main meals with one or two sachets of formula diet (170-340 kcal). The other two meals were set to 600 kcal. The dietary therapy was implemented approximately 1 month before the operation. Weight loss achieved after dietary therapy ranged from 6.4% to 14.1% (p < 0.01). With the exception of one case, the decrease in visceral fat area ranged from 17.0%-40.7% (p = 0.03). Postoperative complications were anastomotic insufficiency in two cases.

Discussion: Although the decreases of the visceral fat were effectively implemented, the adverse effects on postoperative complications must be examined in the farther study.

Conclusion: It was suggested that use of formula diet to achieve preoperative visceral fat reduction in a short period of time immediately prior to highly invasive endoscopic cancer surgery would be an effective and safe strategy.