Preoperative sarcopenia predictor of pneumonia after laparoscopic esophagectomy for esophageal cancer
Esophageal cancer is one of the most common malignancies and has a poor prognosis despite advancements in treatment . Esophagectomy is the mainstay of curative therapy for locoregional diseases. Although the adoption of minimally invasive esophagectomy (MIE), such as thoracoscopic–laparoscopic esophagectomy (TLE), is increasing, postoperative pulmonary complications continue to occur.
Researchers have found in a new study that Preoperative sarcopenia is a confirmed predictor of postoperative pneumonia among patients undergoing thoracoscopic-laparoscopic esophagectomy for esophageal cancer.
The study has been published in Surgery Today.
This study identified the relationship between postoperative pneumonia and preoperative sarcopenia as well as the factors for preoperative sarcopenia in patients with esophageal cancer.
In this retrospective, single-center, observational study, we evaluated the data of 274 patients who were scheduled for thoracoscopic-laparoscopic esophagectomy. Sarcopenia was defined using the skeletal muscle index, handgrip strength, and gait speed. The physical activity and nutritional status were evaluated. A multivariate logistic regression analysis was performed to confirm the association between sarcopenia and postoperative pneumonia and identify sarcopenia-related factors. A Spearman’s correlation analysis was used to identify the relationship between physical activity and nutritional status.
Results
Age, male sex, sarcopenia, and postoperative recurrent laryngeal nerve palsy were significantly associated with postoperative pneumonia.
Age, male sex, physical activity, and nutritional status were significantly associated with preoperative sarcopenia.
There was a significant correlation between physical activity and nutritional status.
Preoperative sarcopenia was confirmed to be a predictor of postoperative pneumonia. Furthermore, age, sex, physical activity, and nutritional status were significantly associated with preoperative sarcopenia. Physical activity and nutritional status are closely associated with each other in patients with esophageal cancer. A multidisciplinary approach to preoperative sarcopenia, taking exercise and nutrition into account, is recommended.
Reference:
Fukushima, T., Watanabe, N., Okita, Y. et al. The evaluation of the association between preoperative sarcopenia and postoperative pneumonia and factors for preoperative sarcopenia in patients undergoing thoracoscopic-laparoscopic esophagectomy for esophageal cancer. Surg Today (2023). https://doi.org/10.1007/s00595-022-02620-6
