Sarcopenia is an effective prognostic indicator of postoperative outcomes in laparoscopic-assisted gastrectomy |
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| Institution: | 1. Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China;2. Department of Endocrinology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;3. Department of Gastrointestinal Surgery, Shanghai Tenth People''s Hospital Affiliated to TongJi University, Shanghai, China;4. Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China;1. 2nd Department of General Surgery, Jagiellonian University Medical College, Kopernika 21, 31-501, Kraków, Poland;2. Department of Endoscopic, Metabolic and Soft Tissue Tumors Surgery, University Hospital, Kopernika 21, 31-501, Kraków, Poland;3. Department of Radiology, University Hospital, Kopernika 21, 31-501, Kraków, Poland;4. Stanley Dudrick Memorial Hospital, Tyniecka 15, 32-050, Skawina, Poland;1. Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;2. Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, 105-8470, Japan;3. Department of Bariatric & Metabolic Care, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;1. Department of Obstetrics and Gynaecology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands;2. GROW School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands;3. Department of General Surgery, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands;4. NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands;5. Department of Radiology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands;6. Department of Radiology, Netherlands Cancer Institute, P.O. Box 90203, 1006 BE Amsterdam, The Netherlands;7. Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands;1. School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia;2. Department of Nutrition and Dietetics, Alfred Health, Melbourne, Australia;3. Department of Radiology, Alfred Health, Melbourne, Australia;4. Department of Medicine, Monash University, Melbourne, Australia;5. Hepaticopancreaticobiliary Surgery Unit, Alfred Health, Melbourne, Australia;6. Department of Surgery, Monash University, Melbourne, Australia;7. Oesophagogastric Bariatric Surgery Unit, Alfred Health, Melbourne, Australia;8. Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada;9. School of Allied Health, And Health Implementation Science and Technology, Health Research Institute, University of Limerick, Limerick, Ireland;1. Department of General Surgery, Shaare Zedek Medical Centre, Jerusalem, Israel;2. Department of Radiology, Shaare Zedek Medical Centre, Jerusalem, Israel;1. Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang Province, China;2. Department of Gastrointestinal Surgery, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang Province, China |
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| Abstract: | BackgroundThe association between sarcopenia and postoperative outcomes in patients who undergo laparoscopic-assisted gastrectomy is unclear. We aimed to determine the predictive value of sarcopenia for adverse postoperative outcomes after laparoscopic-assisted gastrectomy for gastric cancer.Materials and methodsWe prospectively collected the clinical data of patients who underwent elective radical laparoscopic-assisted gastrectomy for gastric cancer in two large centers from August 2014 to October 2017. The third lumbar vertebra skeletal muscle index, handgrip strength, and 6-m usual gait speed were measured to diagnose sarcopenia. Subsequently, we aimed to identify the risk factors for postoperative complications.ResultsThe study included 313 patients and 37 (11.8%) patients were classified as sarcopenic. Compared with non-sarcopenic patients, sarcopenic patients were significantly older (P < 0.001), had higher nutritional risk screening 2002 scores (P = 0.013), Charlson comorbidity index (CCI) scores (P = 0.033), and neutrophil to lymphocyte ratio (P = 0.004), and lower body mass index (P < 0.001), preoperative serum albumin (P < 0.001), and hemoglobin (P < 0.001). Sarcopenic patients had higher postoperative complication rate (P = 0.002), longer postoperative hospital stays (P = 0.020) and higher total cost of hospitalization (P = 0.001). Multivariate analysis revealed that CCI score ≥1 (odds ratio OR]: 2.424, 95% confidence interval CI]: 1.309–4.487; P = 0.005) and sarcopenia (OR: 2.752, 95% CI: 1.274–5.944; P = 0.010) were independent risk factors for short-term postoperative complications.ConclusionSarcopenia is an independent clinical predictor of short-term postoperative complications after laparoscopic-assisted gastrectomy. |
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| Keywords: | Sarcopenia Laparoscopic-assisted Gastrectomy Gastric cancer Postoperative complications |
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