Department of Thoracic Surgery, Yedikule Training & Research Hospital for Chest Diseases & Surgery, Health Science University, Istanbul, Turkey.
Department of Anesthesiology, Yedikule Training & Research Hospital for Chest Diseases & Surgery, Health Science University, Istanbul, Turkey.
Indian J Med Res. 2021 May;154(5):723-731. doi: 10.4103/ijmr.IJMR_909_19.
BACKGROUND & OBJECTIVES: Sarcopaenia refers to the pathological loss of muscle mass that may be observed in malnutrition, immobility, chronic disease, particularly chronic obstructive pulmonary disease and malignancies. A relationship has been identified between sarcopaenia and thoracic surgery. The aim of the present study was to investigate the relationship between density and area of the psoas major muscle (PSM), the pectoralis major and minor muscles (PEC) and the post-operative morbidity, mortality and survival of patients undergoing anatomic lung resection.
A retrospective review of the medical record data of the patients who underwent lung resection was conducted in between 2009 and 2018. The study included patients who underwent upper abdominal computed tomography (CT) for the measurement of PSM and thoracic CT for PEC. The demographic data, laboratory test results, radiological findings and the survival data of the patients were recorded.
Evaluation was made of 161 patients with available CT data. With the exception of mean PEC density, the PEC parameters (P=0.013-0.026), and PSM density (P=0.015) were significantly lower in the non-survivors than in the survivors. In general, the mean measurements of the PSM and PEC were seen to affect mortality (P=0.001-0.024).
INTERPRETATION & CONCLUSIONS: The mean area and density measurements in the PSM, and particularly in the PEC, were determined to be significantly higher in patients who survived after lung cancer surgery, suggesting that sarcopaenia could be a useful predictor of post-operative mortality risk and survival.
肌肉减少症是指肌肉质量的病理性丧失,可能发生在营养不良、活动受限、慢性疾病,特别是慢性阻塞性肺疾病和恶性肿瘤中。肌肉减少症与胸外科之间存在关联。本研究旨在探讨行解剖性肺切除术患者的腰大肌(PSM)、胸大肌和胸小肌(PEC)密度和面积与术后发病率、死亡率和生存率之间的关系。
回顾性分析 2009 年至 2018 年间行肺切除术患者的病历资料。本研究纳入了行上腹部 CT(PSM 测量)和胸部 CT(PEC 测量)的患者。记录患者的人口统计学数据、实验室检查结果、影像学发现和生存数据。
共评估了 161 例有 CT 数据的患者。除了 PEC 密度的平均值外,非幸存者的 PEC 参数(P=0.013-0.026)和 PSM 密度(P=0.015)均显著低于幸存者。总体而言,PSM 和 PEC 的平均测量值与死亡率有关(P=0.001-0.024)。
肺癌手术后存活患者的 PSM 和 PEC 的平均面积和密度测量值显著更高,表明肌肉减少症可能是术后死亡率和生存率的一个有用预测指标。