School of Medicine, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland.
Skin Wounds and Trauma Research Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
Int J Colorectal Dis. 2023 Feb 9;38(1):29. doi: 10.1007/s00384-023-04329-5.
Sarcopenia is a multifactorial loss of muscle mass that can complicate surgical outcomes and increase morbidity and mortality. Parastomal hernias can occur after any surgery requiring stoma formation and is an area of concern as a complication as it can require a second surgery or emergency surgical intervention.
To assess the impact of sarcopenia on parastomal hernia formation in the postoperative period.
A systematic search of publications using MEDLINE, CINAHL, and Cochrane databases was conducted in June 2022. Data were extracted, and a narrative synthesis was undertaken. The Crowe Critical Appraisal Tool (CCAT) assessed the quality of the included studies. The systematic review included original research studies, prospective and retrospective designs, and human studies written in English. Reviews, conference papers, opinion papers, and those including participants < 18 years old were excluded. No restrictions on the date of publication and study setting were applied.
Nine studies met the inclusion criteria, and these were conducted between 2016 and 2021; 56% (n = 5) used a retrospective study design. The mean sample size was 242.5 participants (SD = ±358.6). No consistent or standardized way of defining sarcopenia or measuring muscle mass was seen between the studies reviewed. However, 45% (n = 4) of the studies reported a significant relationship between sarcopenia and wound healing complications, including an increased incidence of parastomal and incisional hernias. The average CCAT score was 27.56 (SD = ±4.39).
There is no definitive relationship between sarcopenia and hernia development; however, four studies found a significant relationship between sarcopenia and hernia formation. It must also be considered that different disease processes can cause sarcopenia either through the disease process itself, or the treatment and management. More research and consistent measurements are needed before comparable and consistent outcomes can be compiled.
肌少症是一种多因素导致的肌肉质量下降，可使手术结果复杂化，并增加发病率和死亡率。造口旁疝可发生于任何需要造口的手术后，是一种令人担忧的并发症，因为它可能需要再次手术或紧急手术干预。
评估肌少症对术后造口旁疝形成的影响。
2022 年 6 月，使用 MEDLINE、CINAHL 和 Cochrane 数据库对出版物进行了系统检索。提取数据并进行叙述性综合分析。使用 Crowe 批判性评估工具（CCAT）评估纳入研究的质量。系统综述纳入了原始研究、前瞻性和回顾性设计以及用英语撰写的人类研究。排除了综述、会议论文、观点论文以及包含参与者年龄<18 岁的研究。未对发表日期和研究地点进行限制。
符合纳入标准的研究有 9 项，这些研究的开展时间在 2016 年至 2021 年之间；56%（n=5）使用回顾性研究设计。平均样本量为 242.5 名参与者（SD=±358.6）。在综述的研究中，没有看到关于肌少症或肌肉质量测量的一致或标准化定义方法。然而，45%（n=4）的研究报告了肌少症与伤口愈合并发症之间存在显著关系，包括造口旁疝和切口疝的发生率增加。平均 CCAT 评分为 27.56（SD=±4.39）。
肌少症与疝的发生之间没有明确的关系；然而，四项研究发现肌少症与疝的形成之间存在显著关系。还必须考虑到，不同的疾病过程可能通过疾病本身或治疗和管理导致肌少症。在能够编制可比和一致的结果之前，需要进行更多的研究和一致的测量。
