Tojek Krzysztof, Banaszkiewicz Zbigniew, Budzyński Jacek
Department of General, Gastrointestinal, Colorectal, and Oncological Surgery, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.
Department of Vascular and Internal Diseases, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.
Prz Gastroenterol. 2021;16(1):47-55. doi: 10.5114/pg.2021.104736. Epub 2021 Mar 26.
Nutritional status assessment is an important part of preoperative patient evaluation, but the standard anthropometric parameters do not appear to be adequate.
To determine the changes in the values of bioelectrical impedance analysis (BIA) parameters in patients 3 months after undergoing surgery for colorectal cancer (CRC).
BIA and nutritional status assessment parameters were determined in 80 patients prior to undergoing surgery for CRC. The results 3 months after surgery for 64 of those patients were then compared with their initial assessments.
According to standard WHO ranges, 54% of the patients were diagnosed as being overweight and 29% as obese. The percentage of patients categorized as obese amounted to 56% when this was defined as high fat mass. Moderate sarcopaenia, defined as a low skeletal muscle index (SMI) or low percentage of skeletal muscle mass, was diagnosed in 21% and 29% of patients, respectively. Patients with postoperative weakness that made it impossible for them to attend the control visit had a lower preoperative skeletal muscle mass ( = 0.01) and SMI value ( = 0.001). Parameters of BIA did not discriminate patients with postoperative complications, which occurred in 23% of individuals enrolled.
A significant proportion of the patients undergoing surgery for CRC were overweight or obese, which could mask the sarcopaenia that presented in 21-29% of them. Sarcopaenia was the only parameter predictive of a postoperative decrease in performance status.
营养状况评估是术前患者评估的重要组成部分,但标准人体测量参数似乎并不足够。
确定结直肠癌(CRC)手术3个月后患者生物电阻抗分析(BIA)参数值的变化。
对80例接受CRC手术的患者术前进行BIA和营养状况评估参数测定。然后将其中64例患者术后3个月的结果与其初始评估结果进行比较。
根据世界卫生组织(WHO)的标准范围,54%的患者被诊断为超重,29%为肥胖。当将肥胖定义为高脂肪量时,肥胖患者的比例达56%。分别有21%和29%的患者被诊断为中度肌肉减少症,定义为低骨骼肌指数(SMI)或低骨骼肌质量百分比。术后身体虚弱无法参加对照访视的患者术前骨骼肌质量较低(P = 0.01),SMI值也较低(P = 0.001)。BIA参数无法区分发生术后并发症的患者,23%的入组个体出现了术后并发症。
接受CRC手术的患者中很大一部分超重或肥胖,这可能掩盖了21%至29%患者存在的肌肉减少症。肌肉减少症是术后体能状态下降的唯一预测指标。