Surgical Clinic Mureș County Clinical Hospital, "G.E. Palade" University of Medicine, Pharmacy, Science and Technology of Târgu Mureş, 540142 Târgu Mureș, Romania.
Surgical Clinic Mureș County Clinical Hospital, 540103 Târgu Mureș, Romania.
Medicina (Kaunas). 2021 May 11;57(5):472. doi: 10.3390/medicina57050472.
: Sarcopenia is a recognized prognostic factor for both complications and survival in cancer patients. This study aims to analyze the relationship between sarcopenia measured by psoas muscle index on computer tomography scans and the presence of postoperative complications in colorectal cancer surgery. : In a prospective study we recorded data from 51 patients who underwent colorectal cancer surgery in the Mures County Clinical Hospital, Romania. Total psoas muscle area and psoas density were measured at the level of the third lumbal vertebra (L3) for further index calculation. We also evaluated the general characteristics and laboratory analyses to obtain more information about status of the patients. Short-term postoperative complications were scored according to the Clavien-Dindo classification. : The majority of the 51 patients were male (61%) and the median age was 65 years. More than half of the cancer was located in the rectum (56.9%), a quarter in the right colon (25.5%), the rest in the sigmoid (11.8%), and the left colon (5.9%). Twenty-one patients (41.2%) developed a complication, five (9.8%) of these were Clavien-Dindo grade 3, 4 or 5 (high grade) and sixteen (31.3%) grade 1 or 2 (low grade). The low- and high-grade groups showed a significantly lower right psoas muscle area, left psoas muscle area, total psoas muscle area, and psoas muscle index ( < 0.001 in all cases). Among laboratory analyses, a significantly lower perioperative hematocrit, hemoglobin, and albumin level were found in patients who developed complications. Furthermore we observed that an elevated serum C-reactive protein level was associated with a higher grade of complication ( < 0.043). : The psoas muscle index (PMI) influence on the postoperative outcome is an important factor in our single center prospective study and it appears to be a good overall predictor in colorectal surgery. A lower PMI is directly associated with a low or high grade complication by Clavien-Dindo classification. Perioperative inflammatory and nutritional status evidenced by serum C-reactive protein (CRP) and albumin level influences the presence of postoperative complications.
肌肉减少症是癌症患者并发症和生存的公认预后因素。本研究旨在分析计算机断层扫描测量的腰椎旁肌指数与结直肠癌手术后并发症发生的关系。
在一项前瞻性研究中，我们记录了在罗马尼亚穆雷什县临床医院接受结直肠癌手术的 51 名患者的数据。在第三腰椎（L3）水平测量总腰椎旁肌面积和腰椎旁肌密度，以进一步计算指数。我们还评估了一般特征和实验室分析，以获得更多关于患者状况的信息。根据 Clavien-Dindo 分类对短期术后并发症进行评分。
51 名患者中大多数为男性（61%），中位年龄为 65 岁。超过一半的癌症位于直肠（56.9%），四分之一位于右结肠（25.5%），其余位于乙状结肠（11.8%）和左结肠（5.9%）。21 名患者（41.2%）发生并发症，其中 5 名（9.8%）为 Clavien-Dindo 3 级、4 级或 5 级（高级），16 名（31.3%）为 1 级或 2 级（低级）。低级别和高级别组的右侧腰椎旁肌面积、左侧腰椎旁肌面积、总腰椎旁肌面积和腰椎旁肌指数明显较低（所有情况下均<0.001）。在实验室分析中，发生并发症的患者围手术期的血细胞比容、血红蛋白和白蛋白水平明显较低。此外，我们观察到血清 C 反应蛋白水平升高与并发症程度较高相关（<0.043）。
在我们的单中心前瞻性研究中，腰椎旁肌指数（PMI）对术后结果的影响是一个重要因素，它似乎是结直肠手术的一个很好的整体预测指标。较低的 PMI 与 Clavien-Dindo 分级的低或高等级并发症直接相关。血清 C 反应蛋白（CRP）和白蛋白水平等围手术期炎症和营养状态影响术后并发症的发生。
