Role of sarcopenia in complex abdominal wall surgery: does it increase postoperative complications and mortality?

Autor: Santana Valenciano Á; General and Digestive Surgery Department, University Hospital Ramón y Cajal, Ctra. de Colmenar Viejo, Km. 9,100, 28034, Madrid, Spain.; Universidad de Alcalá, Alcalá de Henares, Spain., Blázquez Hernando L; General and Digestive Surgery Department, University Hospital Ramón y Cajal, Ctra. de Colmenar Viejo, Km. 9,100, 28034, Madrid, Spain. la_blazquez@hotmail.com.; Universidad de Alcalá, Alcalá de Henares, Spain. la_blazquez@hotmail.com., Robín Valle de Lersundi Á; General and Digestive Surgery Department, University Hospital Henares, Coslada, Spain., López Monclús J; General and Digestive Surgery Department, University Hospital Puerta de Hierro, Majadahonda, Spain., Muñoz Rodríguez J; General and Digestive Surgery Department, University Hospital Puerta de Hierro, Majadahonda, Spain., Porrero Guerrero B; General and Digestive Surgery Department, University Hospital Ramón y Cajal, Ctra. de Colmenar Viejo, Km. 9,100, 28034, Madrid, Spain.; Universidad de Alcalá, Alcalá de Henares, Spain., Román García de León L; General and Digestive Surgery Department, University Hospital Puerta de Hierro, Majadahonda, Spain., Molina Villar JM; General and Digestive Surgery Department, University Hospital Ramón y Cajal, Ctra. de Colmenar Viejo, Km. 9,100, 28034, Madrid, Spain.; Universidad de Alcalá, Alcalá de Henares, Spain., Medina Pedrique M; General and Digestive Surgery Department, University Hospital Henares, Coslada, Spain., Blázquez Sánchez J; Radiology Department, University Hospital Ramón y Cajal, Madrid, Spain.; Universidad de Alcalá, Alcalá de Henares, Spain., Fernández Cebrián JM; General and Digestive Surgery Department, University Hospital Ramón y Cajal, Ctra. de Colmenar Viejo, Km. 9,100, 28034, Madrid, Spain.; Universidad de Alcalá, Alcalá de Henares, Spain., García Ureña MÁ; General and Digestive Surgery Department, University Hospital Henares, Coslada, Spain.; Universidad Francisco de Vitoria, Madrid, Spain.
Jazyk: angličtina
Zdroj: Hernia : the journal of hernias and abdominal wall surgery [Hernia] 2024 Dec; Vol. 28 (6), pp. 2375-2386. Date of Electronic Publication: 2024 Sep 24.
DOI: 10.1007/s10029-024-03174-x
Abstrakt: Background: Sarcopenia is defined as the loss of skeletal muscle mass and is associated with an increased risk or morbidity and mortality in complex surgical patient populations. Its role in complex abdominal wall surgery (AWS) is yet to be determined. The aim of this study is to establish if sarcopenia has an impact on postoperative complications, mortality and hernia recurrence.
Methods: Retrospective study of patients undergoing elective surgery for complex incisional hernias > 10 cm (W3 of European Hernia Society classification) between 2014-2023. Sarcopenia was stablished as the skeletal muscle index (SMI), measured at L3 transversal section of a preoperative CT-scan. Previously defined literature-based SMI cutoff values were used: men ≤ 52.4 cm 2 /m 2 , women ≤ 38.5 cm 2 /m 2 .
Results: 135 patients undergoing complex AWS were included. Of them, 38 were sarcopenic (28.1%). The median follow-up time was 13 months (IQR 12-25). In total, 11 patients died (8.1%). We found that sarcopenia was associated with a higher risk of mortality [HR 7.494 (95% CI 1.985-28.289); p 0.003]. There were no statistically significant differences in postoperative complications or hernia recurrence between both groups.
Conclusion: Although sarcopenia does not seem to have an influence on hernia recurrence or the development of postoperative complications, whether local or systemic, in our study sarcopenia is associated with a higher risk of mortality after complex abdominal wall surgery. Nonetheless, with the results obtained in our study, we think that prehabilitation programs before complex AWS is advisable.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)
Databáze: MEDLINE
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