Hogenbirk Rianne N M, Hentzen Judith E K R, van der Plas Willemijn Y, Campmans-Kuijpers Marjo J E, Kruijff Schelto, Klaase Joost M
Department of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands.
Department of Surgery, Amsterdam University Medical Center, 1105 AZ Amsterdam, The Netherlands.
Cancers (Basel). 2023 Feb 3;15(3):969. doi: 10.3390/cancers15030969.
To study the occurrence of surgery-related muscle loss (SRML) and its association with in-hospital nutritional intake, we conducted a prospective observational cohort study including patients who underwent pancreatic surgery because of (suspected) malignant diseases. Muscle diameter was measured by using bedside ultrasound 1 day prior to surgery and 7 days postoperatively. Clinically relevant SRML was defined as ≥10% muscle diameter loss in minimally one arm and leg muscle within 1 week after surgery. Protein and caloric intake was measured by nutritional diaries. The primary endpoint included the number of patients with SRML. Secondary endpoints included the association between SRML and postoperative nutritional intake. Of the 63 included patients (60.3% men; age 67.1 ± 10.2 years), a total of 24 patients (38.1%) showed SRML. No differences were observed in severe complication rate or length of hospital stay between patients with and without SRML. During the first postoperative week, patients with clinically relevant SRML experienced more days without any nutritional intake compared with the non-SRML group (1 [0-4] versus 0 [0-1] days, = 0.007). Significantly lower nutritional intake was found in the SRML group at postoperative days 2, 3 and 5 ( < 0.05). Since this study shows that SRML occurred in 38.1% of the patients and most of the patients failed to reach internationally set nutritional goals, it is suggested that more awareness concerning direct postoperative nutritional intake is needed in our surgical community.
为研究手术相关肌肉丢失（SRML）的发生情况及其与住院期间营养摄入的关系，我们开展了一项前瞻性观察性队列研究，纳入因（疑似）恶性疾病接受胰腺手术的患者。术前1天及术后7天采用床旁超声测量肌肉直径。临床相关的SRML定义为术后1周内至少一侧手臂和腿部肌肉直径损失≥10%。通过营养日记测量蛋白质和热量摄入。主要终点包括发生SRML的患者数量。次要终点包括SRML与术后营养摄入之间的关联。在纳入的63例患者中（男性占60.3%；年龄67.1±10.2岁），共有24例患者（38.1%）出现SRML。出现和未出现SRML的患者在严重并发症发生率或住院时间方面未观察到差异。术后第一周，与非SRML组相比，临床相关SRML患者无任何营养摄入的天数更多（1[0 - 4]天对0[0 - 1]天，P = 0.007）。在术后第2、3和5天，SRML组的营养摄入量显著较低（P<0.05）。由于本研究表明38.1%的患者发生了SRML，且大多数患者未达到国际设定的营养目标，因此建议我们的外科界提高对术后直接营养摄入的认识。
