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肌少症与胃癌手术患者手术部位感染的关系。

Relation between Sarcopenia and Surgical Site Infection in Patients Undergoing Gastric Cancer Surgery.

机构信息

Kosuyolu Resarch and Education Hospital, Istanbul, Turkey.

Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey.

出版信息

Surg Infect (Larchmt). 2021 Jun;22(5):551-555. doi: 10.1089/sur.2020.211. Epub 2020 Nov 11.

Abstract

Sarcopenia is a syndrome that can have negative consequences after gastric cancer (GC) surgery. This study aims to determine the effect of sarcopenia on surgical site infection (SSI) that develops after open GC surgery. In this retrospective design study, data were collected for patients who underwent GC surgery between January 2013 and August 2019. The diagnosis of sarcopenia was made according to the skeletal muscle index (SMI) calculated from pre-operative computed tomography images. Patients with sarcopenia and those without sarcopenia were compared in terms of SSIs; the risk factors for SSI were also analyzed. One hundred forty-nine patients were included in the study and had a mean age of 59.3 years. Post-operative complications developed in 59 patients (39.6%) and SSIs in 28 patients (18.7%). Sarcopenia was detected in 57 (38.3%) patients; the mean age was 59.9 years in the sarcopenic group (SG) and 58.9 years in the non-sarcopenic group (NSG; p = 0.55). The mean SMI was 382.5 mm/m and 646.2 mm/m in the SG and NSG, respectively (p < 0.001). A relation between SSIs and sarcopenia was detected; 17 patients in the SG (29.8%) versus 11 patients in the NSG (11.9%; p = 0.007). Surgical site infection was not found to be statistically significantly related to obesity, hypoalbuminemia, intra-operative blood loss, or duration of operation, although the sarcopenic obesity patients were found to have the highest SSI rate (40%). The present study identified a relation between sarcopenia and SSIs occurring after GC surgery. The authors believe that studies seeking to reduce the incidence of SSIs, which are a leading cause of morbidity after GC surgery, should be supported.

摘要

肌肉减少症是胃癌(GC)手术后可能产生负面影响的综合征。本研究旨在确定肌肉减少症对开腹 GC 手术后发生的手术部位感染(SSI)的影响。在这项回顾性设计研究中,收集了 2013 年 1 月至 2019 年 8 月期间接受 GC 手术的患者的数据。根据术前 CT 图像计算的骨骼肌指数(SMI)诊断肌肉减少症。比较了有和无肌肉减少症患者的 SSI 情况;还分析了 SSI 的危险因素。研究纳入了 149 例患者,平均年龄为 59.3 岁。59 例(39.6%)患者发生术后并发症,28 例(18.7%)患者发生 SSI。57 例(38.3%)患者检测到肌肉减少症;肌肉减少症组(SG)的平均年龄为 59.9 岁,非肌肉减少症组(NSG)为 58.9 岁(p=0.55)。SG 和 NSG 的平均 SMI 分别为 382.5mm/m 和 646.2mm/m(p<0.001)。检测到 SSI 与肌肉减少症之间存在关联;SG 中有 17 例(29.8%)患者,NSG 中有 11 例(11.9%)患者(p=0.007)。尽管肌肉减少性肥胖患者的 SSI 发生率最高(40%),但 SSI 与肥胖、低白蛋白血症、术中失血或手术持续时间无统计学显著相关。本研究确定了 GC 手术后肌肉减少症与 SSI 之间的关系。作者认为,应该支持旨在降低 GC 手术后发病率较高的 SSI 发生率的研究。

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