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肌肉减少症是胰十二指肠切除术后胃排空延迟的独立预测因素:一项回顾性研究。

Sarcopenia is an independent predictor of delayed gastric emptying following pancreaticoduodenectomy: a retrospective study.

作者信息

Shintakuya Ryuta, Sasaki Masaru, Nakamitsu Atsushi, Kohyama Mohei, Tazaki Tatsuya, Sugiyama Yoichi, Hirano Toshinori, Kaiki Yuki

机构信息

Department of Surgery, JA Hiroshima General Hospital, Hatsukaichi, Hiroshima, Japan.

出版信息

ANZ J Surg. 2019 Oct;89(10):E433-E437. doi: 10.1111/ans.15379. Epub 2019 Aug 26.

Abstract

BACKGROUND

The pathogenesis of delayed gastric emptying (DGE), a common complication of pancreaticoduodenectomy, is unclear. Loss of skeletal muscle mass (sarcopenia) is associated with post-pancreaticoduodenectomy complications; however, few studies have investigated the relationship between sarcopenia and DGE. The aim of this study was to investigate whether post-pancreaticoduodenectomy DGE is affected by pre-operative skeletal muscle mass.

METHODS

We retrospectively analysed the data of 112 consecutive patients who had undergone pancreaticoduodenectomy and divided them into the following two groups: no DGE (n = 100) and with DGE (n = 12). Patients were stratified by quartiles according to each element of body composition. The lowest quartile for skeletal muscle mass was defined as having sarcopenia.

RESULTS

Ten and two patients had grades B and C DGE, respectively. According to univariate analysis, body mass index (P = 0.031), clinically relevant post-operative pancreatic fistula (P < 0.001) and skeletal muscle mass (P = 0.002) were significantly associated with DGE. According to multivariate analysis, high body mass index (≥25 kg/cm ) (P = 0.005), post-operative pancreatic fistula (P = 0.027) and low skeletal muscle mass (P = 0.004) were independently associated with DGE.

CONCLUSION

Sarcopenia is an independent predictor of DGE after pancreaticoduodenectomy.

摘要

背景

胃排空延迟(DGE)是胰十二指肠切除术常见的并发症,其发病机制尚不清楚。骨骼肌量减少(肌肉减少症)与胰十二指肠切除术后并发症相关;然而,很少有研究探讨肌肉减少症与DGE之间的关系。本研究的目的是调查胰十二指肠切除术后DGE是否受术前骨骼肌量的影响。

方法

我们回顾性分析了112例连续接受胰十二指肠切除术患者的数据,并将他们分为以下两组:无DGE组(n = 100)和有DGE组(n = 12)。根据身体组成的每个元素将患者按四分位数分层。骨骼肌量最低的四分位数被定义为患有肌肉减少症。

结果

分别有10例和2例患者发生B级和C级DGE。单因素分析显示,体重指数(P = 0.031)、临床相关的术后胰瘘(P < 0.001)和骨骼肌量(P = 0.002)与DGE显著相关。多因素分析显示,高体重指数(≥25kg/cm²)(P = 0.005)、术后胰瘘(P = 0.027)和低骨骼肌量(P = 0.004)与DGE独立相关。

结论

肌肉减少症是胰十二指肠切除术后DGE的独立预测因素。

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