Aaron L Womer1, Justin T Brady1, Kevin Kalisz2, Nilam D Patel1, Raj M Paspulati2, Harry L Reynolds1, Timothy M Pawlik3, Scott R Steele4. 1. Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA. 2. Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA. 3. Department of Surgery, Ohio State University Medical Center, Columbus, OH, USA. 4. Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Department of Colorectal Surgery, Cleveland Clinic, Cleveland, OH, USA. Electronic address: Steeles3@ccf.org.
Abstract
BACKGROUND: Increasingly, patients with multiple co-morbidities undergo surgery for rectal cancer. We aimed to evaluate if decreased psoas muscle area and volume, as measures for sarcopenia, were associated with postoperative morbidity. METHODS: Retrospective review of patients undergoing rectal cancer resection at a tertiary medical center (2007-2015). Variables included demographics, co-morbidities, preoperative psoas muscle area and volume, and postoperative complications. RESULTS: Among 180 patients (58% male, mean age 62.7 years), 44% experienced complications (n = 79), of which 38% (n = 30) were major complications. Malnourished patients had smaller height-adjusted total psoas area than non-malnourished patients (6.4 vs. 9.5 cm2/m2, p = 0.004). Among patients with imaging obtained within 90 days of surgery, major morbidity was associated with smaller total psoas area (6.7 vs. 10.5 cm2/m2, p = 0.04) and total psoas volume (26.7 vs. 42.2 cm3/m2, p = 0.04) compared to those with minor complications. CONCLUSION: Preoperative cross-sectional imaging may help surgeons anticipate postoperative complications following rectal cancer surgery.
BACKGROUND: Increasingly, patients with multiple co-morbidities undergo surgery for rectal cancer. We aimed to evaluate if decreased psoas muscle area and volume, as measures for sarcopenia, were associated with postoperative morbidity. METHODS: Retrospective review of patients undergoing rectal cancer resection at a tertiary medical center (2007-2015). Variables included demographics, co-morbidities, preoperative psoas muscle area and volume, and postoperative complications. RESULTS: Among 180 patients (58% male, mean age 62.7 years), 44% experienced complications (n = 79), of which 38% (n = 30) were major complications. Malnourished patients had smaller height-adjusted total psoas area than non-malnourished patients (6.4 vs. 9.5 cm2/m2, p = 0.004). Among patients with imaging obtained within 90 days of surgery, major morbidity was associated with smaller total psoas area (6.7 vs. 10.5 cm2/m2, p = 0.04) and total psoas volume (26.7 vs. 42.2 cm3/m2, p = 0.04) compared to those with minor complications. CONCLUSION: Preoperative cross-sectional imaging may help surgeons anticipate postoperative complications following rectal cancer surgery.
Authors: Biljana Gigic; Johanna Nattenmüller; Martin Schneider; Yakup Kulu; Karen L Syrjala; Jürgen Böhm; Petra Schrotz-King; Hermann Brenner; Graham A Colditz; Jane C Figueiredo; William M Grady; Christopher I Li; David Shibata; Erin M Siegel; Adetunji T Toriola; Hans-Ulrich Kauczor; Alexis Ulrich; Cornelia M Ulrich Journal: Nutrients Date: 2020-04-28 Impact factor: 5.717