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Low muscularity increases the risk for post-operative pneumonia and delays recovery from complications after oesophago-gastric cancer resection.
Murnane, Lisa C; Forsyth, Adrienne K; Koukounaras, Jim; Pilgrim, Charles H C; Shaw, Kalai; Brown, Wendy A; Mourtzakis, Marina; Tierney, Audrey C; Burton, Paul R.
Afiliación
  • Murnane LC; School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
  • Forsyth AK; Department of Nutrition and Dietetics, Alfred Health, Melbourne, Victoria, Australia.
  • Koukounaras J; School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
  • Pilgrim CHC; Department of Radiology, Alfred Health, Melbourne, Victoria, Australia.
  • Shaw K; Department of Medicine, Monash University, Melbourne, Victoria, Australia.
  • Brown WA; Department of Surgery, Monash University, Melbourne, Victoria, Australia.
  • Mourtzakis M; Department of Surgery, Monash University, Melbourne, Victoria, Australia.
  • Tierney AC; Hepaticopancreaticobiliary Surgery Unit, Alfred Health, Melbourne, Victoria, Australia.
  • Burton PR; Department of Surgery, Monash University, Melbourne, Victoria, Australia.
ANZ J Surg ; 91(12): 2683-2689, 2021 Dec.
Article en En | MEDLINE | ID: mdl-34580983
BACKGROUND: Low muscularity is associated with adverse surgical outcomes. We aimed to determine whether low muscularity is associated with an increased risk of post-operative complications and reduced long-term survival after oesophago-gastric cancer surgery. METHODS: Patients who underwent radical oesophago-gastric cancer surgery with preoperative abdominal computed tomography (CT) imaging were included. Low skeletal muscle index (SMI), measured by CT, was determined using pre-defined cut-points. Oncological, surgical, complications and outcome data were obtained from a prospective database. RESULTS: Of 108 patients, 61% (n = 66) had low SMI preoperatively. Patients with low SMI had a higher rate of post-operative pneumonia (30 vs. 7% normal muscularity, P = 0.004). Median length of stay (LOS) was higher in patients with low SMI if they had any complication (19.5 vs. 14 days, P = 0.026) or pneumonia (21 vs. 13 days, P = 0.018). On multivariate analysis, low SMI (OR 3.85, CI 1.10-13.4, P = 0.025), preoperative weight loss (OR 1.13, CI 1.01-1.25, P = 0.027), and smoking (OR 5.08, CI 1.24-20.9, P = 0.024) were independent predictors of having a severe complication. There was no difference in 5-year overall (62% vs. 69%, P = 0.241) and disease-free (11% vs. 21.4%, P = 0.110) survival between low SMI and normal muscle mass groups. CONCLUSION: Low SMI is associated with a significantly increased risk of pneumonia and increased LOS for patients with complications. Assessment of muscle mass may require additional muscle quality, strength, and physical performance measures to enhance preoperative risk assessment.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumonía / Neoplasias Gástricas Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: ANZ J Surg Año: 2021 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Australia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumonía / Neoplasias Gástricas Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: ANZ J Surg Año: 2021 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Australia