Department of Digestive Surgery, Hôtel-Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon.
Department of Radiology, Hôtel-Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon.
Surg Technol Int. 2024 Jul 15;44:143-156. doi: 10.52198/24.STI.44.GS1803.
Surgery for colorectal cancer (CRC) is not risk-free; therefore, preoperative evaluation must be done to predict and prevent surgical complications. Sarcopenia, a loss of muscle mass and function, was shown to be associated with surgical complications. Our study evaluates the effects of sarcopenia on short-term patient outcomes after CRC resection.
Our retrospective study included patients with histologically proven CRC between 2018 and 2020 who underwent surgical resection. Skeletal muscle mass (cm2) was evaluated on a preoperative CT scan at the level of L3 vertebrae then standardized using stature (m2) to obtain the skeletal mass index (SMI) (cm2/m2). Patients received proper adjuvant care if needed and were followed up 90 days post surgery. Descriptive statistics were presented in percentage for categorical variables and in mean for continuous variables. Multivariate was made by linear regression.
113 patients were included, and 15% were sarcopenic. A statistically non-significant association was found between sarcopenia and severe complications (grade III-IV) (23.53% in sarcopenic vs. 9.38% non-sarcopenic, p=0.02, multivariate p=0.675). Sarcopenia was not associated with anastomotic leakage, infectious complications, or ileus or intra-abdominal bleeding (p>0.05). In literature, some studies showed an association between sarcopenia and postoperative complications while others showed no relationship between the two. Most studies used SMI.
A non-statistically significant association was found between sarcopenia and postoperative complications in CRC patients. Sarcopenia does not predict postoperative severe complications, anastomotic leakage, infectious complications, or ileus or intra-abdominal bleeding. Emergent surgeries and age >60 years were associated with more postoperative complications.
结直肠癌(CRC)的手术并非没有风险;因此,必须进行术前评估,以预测和预防手术并发症。肌肉减少症,即肌肉质量和功能的丧失,与手术并发症有关。我们的研究评估了肌肉减少症对 CRC 切除术后短期患者结局的影响。
我们的回顾性研究纳入了 2018 年至 2020 年间接受手术切除的组织学证实的 CRC 患者。在 L3 椎体水平的术前 CT 扫描上评估骨骼肌量(cm2),然后使用身高(m2)标准化以获得骨骼肌指数(SMI)(cm2/m2)。如果需要,患者接受适当的辅助治疗,并在手术后 90 天进行随访。分类变量以百分比表示,连续变量以平均值表示。多元分析采用线性回归。
共纳入 113 例患者,其中 15%为肌肉减少症患者。肌肉减少症与严重并发症(III-IV 级)之间存在统计学上无显著关联(肌肉减少症患者为 23.53%,非肌肉减少症患者为 9.38%,p=0.02,多元分析 p=0.675)。肌肉减少症与吻合口漏、感染性并发症、肠梗阻或腹腔内出血无关(p>0.05)。在文献中,一些研究表明肌肉减少症与术后并发症之间存在关联,而另一些研究则表明两者之间没有关系。大多数研究使用 SMI。
在 CRC 患者中,肌肉减少症与术后并发症之间存在统计学上无显著关联。肌肉减少症不能预测术后严重并发症、吻合口漏、感染性并发症或肠梗阻或腹腔内出血。急诊手术和年龄>60 岁与更多的术后并发症相关。