Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Am J Surg. 2018 Mar;215(3):503-506. doi: 10.1016/j.amjsurg.2017.10.052. Epub 2017 Nov 21.
Increasingly, patients with multiple co-morbidities undergo surgery for rectal cancer. We aimed to evaluate if decreased psoas muscle area and volume, as measures for sarcopenia, were associated with postoperative morbidity.
Retrospective review of patients undergoing rectal cancer resection at a tertiary medical center (2007-2015). Variables included demographics, co-morbidities, preoperative psoas muscle area and volume, and postoperative complications.
Among 180 patients (58% male, mean age 62.7 years), 44% experienced complications (n = 79), of which 38% (n = 30) were major complications. Malnourished patients had smaller height-adjusted total psoas area than non-malnourished patients (6.4 vs. 9.5 cm/m, p = 0.004). Among patients with imaging obtained within 90 days of surgery, major morbidity was associated with smaller total psoas area (6.7 vs. 10.5 cm/m, p = 0.04) and total psoas volume (26.7 vs. 42.2 cm/m, p = 0.04) compared to those with minor complications.
Preoperative cross-sectional imaging may help surgeons anticipate postoperative complications following rectal cancer surgery.
越来越多患有多种合并症的患者接受直肠癌手术。我们旨在评估是否减少腰大肌面积和体积（作为肌肉减少症的指标）与术后发病率有关。
回顾性分析在一家三级医疗中心接受直肠癌切除术的患者（2007-2015 年）。变量包括人口统计学、合并症、术前腰大肌面积和体积以及术后并发症。
在 180 名患者中（58%为男性，平均年龄 62.7 岁），44%（n=79）发生并发症，其中 38%（n=30）为主要并发症。营养不良患者的身高调整后总腰大肌面积小于非营养不良患者（6.4 与 9.5cm/m，p=0.004）。在手术前 90 天内获得影像学检查的患者中，与轻微并发症相比，主要并发症与总腰大肌面积较小（6.7 与 10.5cm/m，p=0.04）和总腰大肌体积较小（26.7 与 42.2cm/m，p=0.04）相关。
术前横断面成像可能有助于外科医生预测直肠癌手术后的术后并发症。
