Yuksek Ihtisas University, Faculty of Medicine Department of General Surgery, Ankara, Turkey.
Yuksek Ihtisas University, Faculty of Medicine Department of Radiology, Ankara, Turkey.
Surg Oncol. 2021 Jun;37:101527. doi: 10.1016/j.suronc.2021.101527. Epub 2021 Jan 31.
This study was aimed to evaluate the impact of sarcopenia, which was defined by total psoas area (TPA) and total psoas volume (TPV) measurements, on the development of major postoperative complications.
MATERIAL-METHODS: Sarcopenia was assessed in 225 patients with gastrointestinal cancer who underwent surgery between October 2015 and March 2020. The impact of sarcopenia defined by TPA and TPV on major postoperative complications was assessed using multivariate analysis.
Both the median TPA and TPV were higher in men than that in women (p < 0.001). The cut-off value of TPA to define sarcopenia was 526.5 mm/m and 495.68 mm/m for men and women, respectively, and the cut-off value of TPV was 79.6 cm/m for men and 83.1 cm/m for women, While 102 patients (45.3%) had sarcopenia defined by TPA, 54 (24%) had sarcopenia defined by TPV. Seventy-eight patients had at least one complication; 36 (46%) had major complications, and 15 patients died during the study. In logistic regression analysis, only sex was found as a risk factor for the development of sarcopenia (OR = 13.403, p = 0.014). There was a positive correlation between TPA and TPV in male and female patients separately (r = 0.841 and r = 0.883, respectively, p < 0.001). Only sarcopenia defined by TPV was found as a risk factor for the development of major postoperative complication (OR: 35.349, p = 0.028).
Sarcopenia defined by TPV is an independent risk factor in predicting major postoperative complications, not TPA. We believe that volume measurement instead of area is a more accurate method for evaluating sarcopenia in gastrointestinal cancer surgery.
本研究旨在评估通过总腰大肌面积（TPA）和总腰大肌体积（TPV）测量定义的肌肉减少症对主要术后并发症发展的影响。
材料-方法：对 2015 年 10 月至 2020 年 3 月期间接受手术的 225 例胃肠道癌症患者进行肌肉减少症评估。使用多变量分析评估 TPA 和 TPV 定义的肌肉减少症对主要术后并发症的影响。
男性的 TPA 和 TPV 中位数均高于女性（p<0.001）。定义男性和女性肌肉减少症的 TPA 截断值分别为 526.5mm/m 和 495.68mm/m，TPV 截断值为男性 79.6cm/m 和女性 83.1cm/m。102 例患者（45.3%）根据 TPA 定义为肌肉减少症，54 例（24%）根据 TPV 定义为肌肉减少症。78 例患者至少发生一种并发症；36 例（46%）发生主要并发症，15 例患者在研究期间死亡。在逻辑回归分析中，仅性别被发现是肌肉减少症发展的危险因素（OR=13.403，p=0.014）。男性和女性患者的 TPA 和 TPV 之间呈正相关（r=0.841 和 r=0.883，分别，p<0.001）。仅 TPV 定义的肌肉减少症被发现是主要术后并发症发展的危险因素（OR：35.349，p=0.028）。
TPV 定义的肌肉减少症是预测主要术后并发症的独立危险因素，而不是 TPA。我们认为，体积测量而不是面积是评估胃肠道癌症手术中肌肉减少症的更准确方法。
