Department of Clinical Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland.
Laboratory of Theory and Fundamentals of Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland.
In Vivo. 2022 Nov-Dec;36(6):2936-2944. doi: 10.21873/invivo.13036.
BACKGROUND/AIM: Bioelectrical Impedance Analysis is a method that evaluates body composition, useful in assessing the nutritional status of cancer patients. The analysis of its indicators may be helpful in predicting clinical course. The aim of the study was to evaluate the following body composition parameters: fat mass (FM), fat-free mass (FFM), skeletal muscle mass (SMM), muscle mass index (MMI), visceral fat (VF) and body mass index (BMI) measured before and after surgery in patients with gastrointestinal cancer and to determine the relationship between body composition and the course of treatment.
The study included 125 patients, aged 65-68, operated on due to gastric, pancreatic or colorectal cancer. Body composition was assessed with electrical bioimpedance before and on the fifth postoperative day. The severity of complications was assessed with the Clavien-Dindo classification.
In the whole group of patients, the percentage of FM, VF, and BMI levels measured before surgery were significantly higher in curative surgery patients in comparison to palliative surgery patients, p<0.001. The MMI value was also significantly higher, p=0.045. In patients after curative surgery, the values of BMI and FM significantly decreased (BMI - p<0.001; FM - p=0.003) after the surgery. There was no relation between body composition parameters and severity of postoperative complications.
In the investigated group, body composition differed between radical and palliative surgery groups. Surgery with curative intent produced more changes in body composition parameters in the early postoperative period than palliative surgery. These observations may be helpful in prehabilitation planning for such patients.
背景/目的:生物电阻抗分析是一种评估身体成分的方法,可用于评估癌症患者的营养状况。分析其指标可能有助于预测临床病程。本研究旨在评估胃肠道癌患者手术前后的以下身体成分参数:脂肪量(FM)、去脂体重(FFM)、骨骼肌量(SMM)、肌肉质量指数(MMI)、内脏脂肪(VF)和体重指数(BMI),并确定身体成分与治疗过程之间的关系。
本研究纳入了 125 名年龄为 65-68 岁的患者,因胃、胰腺或结直肠癌症接受手术。在手术前和术后第 5 天使用生物电阻抗法评估身体成分。并发症的严重程度采用 Clavien-Dindo 分级进行评估。
在整个患者组中,与姑息性手术患者相比,根治性手术患者手术前的 FM、VF 和 BMI 水平百分比显著更高,p<0.001。MMI 值也显著更高,p=0.045。在根治性手术后的患者中,BMI 和 FM 值在手术后显著降低(BMI:p<0.001;FM:p=0.003)。身体成分参数与术后并发症的严重程度之间无相关性。
在所研究的组中,根治性和姑息性手术组的身体成分存在差异。根治性手术比姑息性手术在术后早期对身体成分参数产生更大的影响。这些观察结果可能有助于此类患者的康复前规划。