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International Journal of Colorectal Disease

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01-01-2020 | Sarcopenia | Original Article

Sarcopenia defined by muscle quality rather than quantity predicts complications following laparoscopic right hemicolectomy

Authors: James Tankel, Shlomo Yellinek, Elena Vainberg, Yotam David, Dmitry Greenman, James Kinross, Petachia Reissman

Published in: International Journal of Colorectal Disease | Issue 1/2020

Abstract

Purpose

While sarcopenia has prognostic value in elective colorectal surgery for predicting peri-operative morbidity and mortality, its role in elective laparoscopic surgery is poorly defined.

Methods

A retrospective single-center analysis of patients undergoing elective laparoscopic right hemicolectomy for adenocarcinoma between January 2010 and December 2016. Univariate analysis compared the robustness of total psoas index (TPI) with Hounsfield unit average calculation (HUAC) calculated from pre-operative CT imaging in predicting post-operative complications. Multivariate analysis compared these measures with American Society of Anesthesiologists (ASA) grade and Charlson scores in predicting post-operative complications.

Results

Of the 580 patients identified, 185 met the inclusion criteria (91 males and 94 females, with a median age of 68). Using TPI and HUAC, 46 and 44 patients respectively were identified as sarcopenic, including 18 patients that were identified by both measures. HUAC-defined sarcopenia was significantly associated with pre-operative comorbidities, peri-operative mortality, and a greater incidence of respiratory, cardiac, and serious post-operative complications (Clavien-Dindo ≥ 3). Those with HUAC-defined sarcopenia aged > 75 were at particular risk of morbidity (OR 5.52, p = 0.002). No such relationships were found with TPI-defined sarcopenia. Only HUAC remained predictive of post-operative complications on multivariate analysis.

Conclusion

Sarcopenia is a novel methodology for stratifying surgical risk in elective colorectal cancer surgery. HUAC has a high prognostic accuracy for the prediction of complications following laparoscopic colorectal surgery compared with TPI, ASA grade, and Charlson score.

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Title: Sarcopenia defined by muscle quality rather than quantity predicts complications following laparoscopic right hemicolectomy
Authors: James Tankel
Shlomo Yellinek
Elena Vainberg
Yotam David
Dmitry Greenman
James Kinross
Petachia Reissman
Publication date: 01-01-2020
Publisher: Springer Berlin Heidelberg
Keywords: Sarcopenia
Hemicolectomy
Hemicolectomy
Colorectal Cancer
Colorectal Cancer
Published in: International Journal of Colorectal Disease / Issue 1/2020
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-019-03423-x

At a glance: The STEP trials

Springer Medicine

Sarcopenia defined by muscle quality rather than quantity predicts complications following laparoscopic right hemicolectomy

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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