Hidehiko Otsuji1, Yukihiro Yokoyama2, Tomoki Ebata1, Tsuyoshi Igami1, Gen Sugawara1, Takashi Mizuno1, Junpei Yamaguchi1, Masato Nagino1. 1. Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. 2. Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. yyoko@med.nagoya-u.ac.jp.
Abstract
BACKGROUND: Several studies have reported that preoperative sarcopenia negatively impacts postoperative outcomes. Meanwhile, changes in skeletal muscle mass during the acute phase after surgery and their association with postoperative complications are unknown. OBJECTIVE: The objective of this study was to investigate the relation between changes in skeletal muscle mass and postoperative complications after major hepatectomy with extrahepatic bile duct resection. METHODS: This study included 254 patients who underwent major hepatectomies with extrahepatic bile duct resections. Total psoas muscle area (TPA) was measured using abdominal computed tomography images obtained before and 1 week after surgery. The percent change in TPA after surgery was calculated. Patients were stratified by sex-specific tertiles according to the extent of muscle mass change by percentage. Surgery-related muscle loss (SML) was defined as the lowest tertile of percent change in TPA. RESULTS: Male patients with a percent change of TPA lower than -5.0 % (n = 54) and female patients with that lower than -2.6 % (n = 31) were included in the lowest tertile and were categorized into a group with SML. The incidence rates of major complications, pancreatic fistula, infectious complications, and mortality were all significantly higher in the group with SML than in the group without SML. By multivariate analyses, SML was identified as an independent factor associated with major complications (odds ratio 3.21; 95 % confidential interval 1.82-5.76, p < 0.001). CONCLUSIONS: SML is significantly associated with postoperative morbidity and mortality in patients who underwent major hepatectomies with extrahepatic bile duct resections.
BACKGROUND: Several studies have reported that preoperative sarcopenia negatively impacts postoperative outcomes. Meanwhile, changes in skeletal muscle mass during the acute phase after surgery and their association with postoperative complications are unknown. OBJECTIVE: The objective of this study was to investigate the relation between changes in skeletal muscle mass and postoperative complications after major hepatectomy with extrahepatic bile duct resection. METHODS: This study included 254 patients who underwent major hepatectomies with extrahepatic bile duct resections. Total psoas muscle area (TPA) was measured using abdominal computed tomography images obtained before and 1 week after surgery. The percent change in TPA after surgery was calculated. Patients were stratified by sex-specific tertiles according to the extent of muscle mass change by percentage. Surgery-related muscle loss (SML) was defined as the lowest tertile of percent change in TPA. RESULTS: Male patients with a percent change of TPA lower than -5.0 % (n = 54) and female patients with that lower than -2.6 % (n = 31) were included in the lowest tertile and were categorized into a group with SML. The incidence rates of major complications, pancreatic fistula, infectious complications, and mortality were all significantly higher in the group with SML than in the group without SML. By multivariate analyses, SML was identified as an independent factor associated with major complications (odds ratio 3.21; 95 % confidential interval 1.82-5.76, p < 0.001). CONCLUSIONS:SML is significantly associated with postoperative morbidity and mortality in patients who underwent major hepatectomies with extrahepatic bile duct resections.
Authors: Nuh N Rahbari; O James Garden; Robert Padbury; Mark Brooke-Smith; Michael Crawford; Rene Adam; Moritz Koch; Masatoshi Makuuchi; Ronald P Dematteo; Christopher Christophi; Simon Banting; Val Usatoff; Masato Nagino; Guy Maddern; Thomas J Hugh; Jean-Nicolas Vauthey; Paul Greig; Myrddin Rees; Yukihiro Yokoyama; Sheung Tat Fan; Yuji Nimura; Joan Figueras; Lorenzo Capussotti; Markus W Büchler; Jürgen Weitz Journal: Surgery Date: 2011-01-14 Impact factor: 3.982
Authors: Alfonso J Cruz-Jentoft; Jean Pierre Baeyens; Jürgen M Bauer; Yves Boirie; Tommy Cederholm; Francesco Landi; Finbarr C Martin; Jean-Pierre Michel; Yves Rolland; Stéphane M Schneider; Eva Topinková; Maurits Vandewoude; Mauro Zamboni Journal: Age Ageing Date: 2010-04-13 Impact factor: 10.668
Authors: Angela B Smith; Allison M Deal; Hyeon Yu; Brian Boyd; Jonathan Matthews; Eric M Wallen; Raj S Pruthi; Michael E Woods; Hyman Muss; Matthew E Nielsen Journal: J Urol Date: 2014-01-11 Impact factor: 7.450
Authors: L M Kuroki; M Mangano; J E Allsworth; C O Menias; L S Massad; M A Powell; D G Mutch; P H Thaker Journal: Ann Surg Oncol Date: 2014-09-05 Impact factor: 5.344
Authors: Paul E Wischmeyer; Zudin Puthucheary; Iñigo San Millán; Daniel Butz; Michael P W Grocott Journal: Curr Opin Crit Care Date: 2017-08 Impact factor: 3.687
Authors: William H Jin; Eric A Mellon; Jessica M Frakes; Gilbert Z Murimwa; Pamela J Hodul; Jose M Pimiento; Mokenge P Malafa; Sarah E Hoffe Journal: J Gastrointest Oncol Date: 2018-02
Authors: Laura van Wijk; Stijn van Duinhoven; Mike S L Liem; Donald E Bouman; Alain R Viddeleer; Joost M Klaase Journal: Eur J Med Res Date: 2021-04-23 Impact factor: 2.175
Authors: Caterina Beatrice Monti; Paolo Righini; Maria Chiara Bonanno; Davide Capra; Daniela Mazzaccaro; Matteo Giannetta; Gabriele Maria Nicolino; Giovanni Nano; Francesco Sardanelli; Massimiliano M Marrocco-Trischitta; Francesco Secchi Journal: J Clin Med Date: 2022-07-12 Impact factor: 4.964