Fujii Arisa, Suzuki Taiki, Sakai Katsuhiko, Matsuura Nobuyuki, Sugahara Keisuke, Katakura Akira, Nomura Takeshi
Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, 101-0061, Japan.
Department of Oral Oncology, Oral and Maxillofacial Surgery, Tokyo Dental College, Chiba, 272-8513, Japan.
Maxillofac Plast Reconstr Surg. 2024 Mar 28;46(1):12. doi: 10.1186/s40902-024-00417-w.
Sarcopenia is characterized by a progressive and generalized loss of skeletal muscle mass and strength. The aim of this retrospective study was to investigate the impact of skeletal muscle mass on adverse events in free-flap reconstruction for defects after oral cancer resection.
Of 120 patients, recipient-site adverse events occurred in 56 patients (46.7%), and recipient-site surgical site infections occurred in 45 patients (37.5%). Skeletal muscle index was significantly associated with recipient-site adverse events in univariate analysis (P < 0.05). Lower body mass index and skeletal muscle index were significantly associated with recipient-site surgical site infection in univariate analysis (P < 0.05). In the multiple logistic regression model, a lower skeletal muscle index was a significant risk factor for recipient-site adverse events and surgical site infections (adverse events odds ratio; 3.17/P = 0.04; surgical site infection odds ratio; 3.76/P = 0.02).
The SMI at level Th12 was an independent factor for postoperative AEs, especially SSI, in OSCC patients with free-flap reconstruction.
肌肉减少症的特征是骨骼肌质量和力量进行性、全身性丧失。这项回顾性研究的目的是调查骨骼肌质量对口腔癌切除术后缺损游离皮瓣重建中不良事件的影响。
120例患者中，56例（46.7%）发生受区不良事件，45例（37.5%）发生受区手术部位感染。单因素分析中，骨骼肌指数与受区不良事件显著相关（P<0.05）。单因素分析中，较低的体重指数和骨骼肌指数与受区手术部位感染显著相关（P<0.05）。在多因素逻辑回归模型中，较低的骨骼肌指数是受区不良事件和手术部位感染的显著危险因素（不良事件比值比；3.17/P=0.04；手术部位感染比值比；3.76/P=0.02）。
在接受游离皮瓣重建的口腔鳞状细胞癌患者中，第12胸椎水平的骨骼肌指数是术后不良事件尤其是手术部位感染的独立因素。
