Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan;
In Vivo. 2024 Nov-Dec;38(6):2827-2835. doi: 10.21873/invivo.13763.
BACKGROUND/AIM: Sarcopenia is diagnosed based on grip strength and skeletal muscle mass. Although decreased skeletal muscle mass has been reported to be associated with poor outcomes after hepatectomy, a few studies have included data on grip strength in hepatectomy candidates. This multicenter study investigated the clinical factors and postoperative complications associated with sarcopenia by assessing the grip strength and skeletal muscle mass in patients undergoing hepatectomy for hepatocellular carcinoma (HCC).
Data from patients who underwent hepatectomy for HCC between January 2020 and March 2022 were retrospectively collected from multi-institutional databases. Sarcopenia was defined as reduced grip strength and skeletal muscle mass. The patients were categorized into the sarcopenia and non-sarcopenia groups, and baseline characteristics and short term outcomes were compared between the two groups.
Overall, 253 patients were included, among which 36 (14.2%) had sarcopenia. The sarcopenia group was significantly associated with older age, low body mass index, comorbid heart or chronic pulmonary disease, cerebrovascular accident history, and overall and major postoperative complications compared to the non-sarcopenia group. Among major postoperative complications [Clavien-Dindo classification (CDC) ≥III], the incidence of bile leakage and intra-abdominal abscess were higher in the sarcopenia group than in the non-sarcopenia group. Multivariate analysis revealed that sarcopenia was an independent risk factor for overall and major postoperative complications (CDC ≥III).
Sarcopenia, defined by grip strength and skeletal muscle mass, is a predictor of overall and major complications after hepatectomy for HCC.
背景/目的：肌少症是基于握力和骨骼肌量来诊断的。虽然骨骼肌量减少与肝切除术后的不良预后有关，但少数研究包括了肝切除候选者的握力数据。这项多中心研究通过评估接受肝细胞癌 (HCC) 肝切除术患者的握力和骨骼肌量，调查了与肌少症相关的临床因素和术后并发症。
从多个机构数据库中回顾性收集了 2020 年 1 月至 2022 年 3 月期间接受 HCC 肝切除术的患者数据。肌少症定义为握力和骨骼肌量减少。将患者分为肌少症和非肌少症组，并比较两组患者的基线特征和短期预后。
共有 253 名患者入组，其中 36 名（14.2%）患有肌少症。与非肌少症组相比，肌少症组患者年龄较大、体重指数较低、合并心脏或慢性肺部疾病、脑血管意外病史，以及整体和主要术后并发症的发生率更高。在主要术后并发症（Clavien-Dindo 分级 (CDC) ≥III 级）中，肌少症组胆漏和腹腔脓肿的发生率高于非肌少症组。多变量分析显示，肌少症是整体和主要术后并发症（CDC ≥III 级）的独立危险因素。
通过握力和骨骼肌量定义的肌少症是 HCC 肝切除术后整体和主要并发症的预测因素。
