术前肌肉减少症与老年食管鳞癌病人术后吻合口瘘的相关性

doi:10.3969/j.issn.1003-9198.2024.12.015

Abstract

Abstract: Objective To explore the relationship between preoperative sarcopenia and postoperative anastomotic leakage in the elderly patients with esophageal squamous cell carcinoma undergoing minimally invasive radical surgery for esophageal cancer. Methods A retrospective analysis was conducted on the clinical data of 953 elderly patients with esophageal squamous cell carcinoma who underwent minimally invasive thoracolaparoscopy combined with radical esophagectomy in the Affiliated Huai’an No.1 People’s Hospital of Nanjing Medical University from January 2020 to December 2022. The incidence of sarcopenia and related clinical and pathological indicators of the patients were recorded, and the correlation between the above indicators and the incidence of postoperative anastomotic leakage was analyzed. Results The incidence rate of postoperative anastomotic leakage in the elderly patients with esophageal squamous cell carcinoma undergoing minimally invasive radical esophagectomy was 4.83%(46/953). Compared with the non-anastomotic leakage group, the anastomotic leakage group had higher proportion of preoperative sarcopenia, postoperative pneumonia and surgery time ＜4 hours (P<0.01). Multivariate Logistic analysis showed that preoperative sarcopenia, postoperative pneumonia and surgery time ＜4 hours were risk factors for postoperative anastomotic leakage in the patients with esophageal squamous cell carcinoma undergoing minimally invasive esophageal cancer radical surgery. Conclusions Preoperative sarcopenia is a high-risk factor for postoperative anastomotic leakage in the elderly patients with esophageal squamous cell carcinoma undergoing minimally invasive radical esophagectomy, and can be used as a key indicator for early preoperative evaluation.

Key words: esophageal cancer, sarcopenia, anastomotic leakage, psoas muscle index, aged

CLC Number:

R 735.1

LU Peng, ZHANG Mingzhi, XU Keping, ZHANG Shaohong, WANG Weimin, TIAN Wenze. Relationship between preoperative sarcopenia and postoperative anastomotic leakage in elderly patients with esophageal squamous cell carcinoma[J]. Practical Geriatrics, 2024, 38(12): 1255-1259.

References

[1] VETTER D, GUTSCHOW C A. Strategies to prevent anastomotic leakage after esophagectomy and gastric conduit reconstruction[J]. Langenbecks Arch Surg, 2020,405(8):1069-1077.
[2] ZHAO Z, CHENG X, SUN X, et al. Prediction model of anastomotic leakage among esophageal cancer patients after receiving an esophagectomy: machine learning approach[J]. JMIR Med Inform, 2021,9(7):e27110.
[3] 于振涛,弓磊,杨月阳,等. 食管癌外科综合治疗进展[J]. 中华消化外科杂志, 2022, 21(1): 30-33.
[4] DUAN X, BAI W, MA Z, et al. Management and outcomes of anastomotic leakage after McKeown esophagectomy:a retrospective analysis of 749 consecutive patients with esophageal cancer[J]. Surg Oncol, 2020,34:304-309.
[5] SOHDA M, KUMAKURA Y, SAITO H, et al.Clinical significance of salvage esophagectomy for patients with esophageal cancer and factors of influencing long-term survival[J]. Anticancer Res, 2017,37(9):5045-5051.
[6] MOTOYAMA S, YAMAMOTO H, MIYATA H, et al. Impact of certification status of the institute and surgeon on short-term outcomes after surgery for thoracic esophageal cancer: evaluation using data on 16,752 patients from the National Clinical Database in Japan[J]. Esophagus, 2020,17(1):41-49.
[7] FABBI M, HAGENS E R C, VAN BERGE HENEGOUWEN M I, et al. Anastomotic leakage after esophagectomy for esophageal cancer: definitions, diagnostics, and treatment[J]. Dis Esophagus, 2021,34(1):doaa039.
[8] JOGIAT U M, SASEWICH H, TURNER S R, et al. Sarcopenia determined by skeletal muscle index predicts overall survival, disease-free survival, and postoperative complications in resectable esophageal cancer: a systematic review and meta-analysis[J]. Ann Surg, 2022,276(5):e311-e318.
[9] SUGIMURA K, MIYATA H, KANEMURA T, et al. Impact of preoperative skeletal muscle mass and physical performance on short-term and long-term postoperative outcomes in patients with esophageal cancer after esophagectomy[J]. Ann Gastroenterol Surg, 2022,6(5):623-632.
[10] MOUG S J, BARRY S J E, MAGUIRE S, et al. Does prehabilitation modify muscle mass in patients with rectal cancer undergoing neoadjuvant therapy? A subanalysis from the REx randomised controlled trial[J]. Tech Coloproctol, 2020,24(9):959-964.
[11] ALEIXO G F P, YU H, CHEN Y T, et al. Myosteatosis evaluation using erector spinae and psoas muscles to predict adverse events during adjuvant chemotherapy for breast cancer[J]. Breast Cancer Res Treat, 2021,186(2):487-495.
[12] LOW DONALD E, ALDERSON D, CECCONELLO I, et al. International consensus on standardization of data collection for complications associated with esophagectomy: Esophagectomy Complications Consensus Group (ECCG)[J]. Ann Surg, 2015,262(2):286-294.
[13] SAKAMOTO T, FUIJIOGI M, MATSUI H, et al. Comparing perioperative mortality and morbidity of minimally invasive esophagectomy versus open esophagectomy for esophageal cancer: a nationwide retrospective analysis[J]. Ann Surg, 2021,274(2):324-330.
[14] MARIETTE C, MAIKAR S R, DABAKURO-YONLI T S, et al. Hybrid minimally invasive esophagectomy for esophageal cancer[J]. N Engl J Med, 2019,380(2):152-162.
[15] FRANSEN L F C, BERKELMANS G H K, ASTI E, et al. The effect of postoperative complications after minimally invasive esophagectomy on long-term survival: an international multicenter cohort study[J]. Ann Surg, 2021,274(6): e1129-e1137.
[16] AOYAMA T, KAZAMA K, ATSUMI Y, et al. Clinical influence of anastomotic leakage on esophageal cancer survival and recurrence[J]. Anticancer Res, 2020,40(1):443-449.
[17] VAN WORKUM F, SLAMAN A E, VAN BERGE HENEGOUWEN M I, et al. Propensity score-matched analysis comparing minimally invasive ivor lewis versus minimally invasive Mckeown esophagectomy[J]. Ann Surg, 2020,271(1):128-133.
[18] TZORTZAKAKIS A, KALARAKIS G, HUANG B, et al. Role ofradiology in the preoperative detection of arterial calcification and celiac trunk stenosis and its association with anastomotic leakage post esophagectomy, an up-to-date review of the literature[J]. Cancers:Basel, 2022,14(4):1016.
[19] 聂洪鑫, 王兵, 杨思豪, 等. 食管癌术后食管胃吻合口瘘危险因素的系统评价与 Meta 分析[J] 中国胸心血管外科临床杂志, 2022, 29(2): 166-178.
[20] TAN X, PENG H, GU P, et al. Prognostic significance of the L3 skeletal muscle index and advanced lung cancer inflammation index in elderly patients with esophageal cancer[J]. Cancer Manag Res, 2021,13:3133-3143.
[21] NISHIGORI T, OKABE H, TANAKA E, et al. Sarcopenia as a predictor of pulmonary complications after esophagectomy for thoracic esophageal cancer[J]. J Surg Oncol, 2016,113(6):678-684.
[22] CHEN F, CHI J, ZHAO B, et al. Impact of preoperative sarcopenia on postoperative complications and survival outcomes of patients with esophageal cancer: a meta-analysis of cohort studies[J]. Dis Esophagus, 2022,35(9):doab100.
[23] PARK A, ORLANDINI M F, SZOR D J, et al. The impact of sarcopenia on esophagectomy for cancer: a systematic review and meta-analysis[J]. BMC Surg, 2023,23(1):240.
[24] 代磊,任自学,张安庆,等.McKeown食管癌术后吻合口瘘的危险因素分析及预测模型建立[J].中国胸心血管外科临床杂志, 2020, 27(12):1436-1440.
[25] 周瑾,马红霞. 食管癌术后颈部吻合口瘘危险因素分析及预测模型的建立[J]. 南京医科大学学报(自然科学版),2023,43(2):268-274,296.
[26] 白成云,李忠诚,李文军,等.食管癌切除术后发生吻合口瘘风险的列线图建立和验证[J].肿瘤代谢与营养电子杂志, 2023, 10(3):401-407.
[27] 赵格非,张坤鹏,高树庚,等.食管癌McKeown术后颈部吻合口瘘危险因素分析[J].中华肿瘤杂志, 2017, 39(4):287-292.
[28] SUGIMOTO A, TOYOKAWA T, MIKI Y, et al. Preoperative C-reactive protein to albumin ratio predicts anastomotic leakage after esophagectomy for thoracic esophageal cancer: a single-center retrospective cohort study[J]. BMC Surg, 2021,21(1):348.

Relationship between preoperative sarcopenia and postoperative anastomotic leakage in elderly patients with esophageal squamous cell carcinoma

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Metrics

Recommended 10

[1]	LI Jiang, QIU Yan, WANG Ting, WANG Dan, YU Yifan, PU Lingli, BU Ling. Correlation between preoperative SII/ALB and clinicopathologic features in elderly patients with lung adenocarcinoma [J]. Practical Geriatrics, 2024, 38(9): 893-896.
[2]	QI Jiaying, YIN Tongtong, WANG Fangfang, ZHANG Hui, WANG Li. A dose-response Meta-analysis of the association between physical activity and the risk of sarcopenia in the elderly [J]. Practical Geriatrics, 2024, 38(9): 905-910.
[3]	DAI Jing, CUI Yan. Correlation between glycosylated hemoglobin variability and cognitive dysfunction in elderly patients with type 2 diabetes mellitus [J]. Practical Geriatrics, 2024, 38(9): 931-935.
[4]	ZHENG Hong, QI Zhenbo, XU Peng, XU Jie, YU Xinyu, ZANG Yanan, ZHANG Zhaoyan. Effects of hypnotics on cognition function and daytime sleepiness in the elderly [J]. Practical Geriatrics, 2024, 38(9): 936-939.
[5]	ZHANG Xingxing, ZHANG Haiyang, HE Xiaojing, LU Xiang. Investigation on the relationship between different physical indexes and the risk of diabetes mellitus in the elderly [J]. Practical Geriatrics, 2024, 38(9): 940-943.
[6]	NI Hongyan, CHEN Yun, ZHANG Qibing, MA Yiming, XIE Chenglan. Effects of electroacupuncture on cognitive function and inflammatory factors in elderly patients undergoing lower limb orthopedic surgery during the perioperative period [J]. Practical Geriatrics, 2024, 38(9): 944-947.
[7]	LI Xiaomin, LI Xiaolin, LI Jie, WU Lei, HAO Ranran. Efficiency influencing factors of transanal double-balloon enteroscopy in elderly patients [J]. Practical Geriatrics, 2024, 38(9): 958-961.
[8]	CAI Huicui, CHEN Yan, WANG Yan, YE Jinjun, ZHU Yuying. Effects of diversified health education model with simple respiratory function exercise on cancer-related fatigue and compliance behavior in elderly patients with lung cancer receiving radiotherapy [J]. Practical Geriatrics, 2024, 38(9): 968-972.
[9]	WANG Xiaojiao, WANG Ning, CUI Hong, YE Tong, WANG Xiaoming. Influence of exercise rehabilitation in elderly patients with mild to moderate chronic heart failure [J]. Practical Geriatrics, 2024, 38(8): 775-778.
[10]	SHEN Chenjun, WANG Xiaoqing, TANG Degang, NING Ping. Correlation between standardized uric acid and renal function in elderly patients with chronic kidney disease aged 90 and over [J]. Practical Geriatrics, 2024, 38(8): 779-782.
[11]	HAO Shijie, ZOU Jianpeng, WEI Chen, LIU Qingjiang. Effect of comprehensive respiratory training on hypokinetic dysarthria in elderly patients with Parkinson’s disease [J]. Practical Geriatrics, 2024, 38(8): 783-787.
[12]	XIANG Chao, LUO Caidong. Analysis of the diagnostic value of T wave change of avL lead for the degree of coronary artery stenosis in elderly patients with coronary heart disease [J]. Practical Geriatrics, 2024, 38(8): 788-791.
[13]	LI Huiying, CAI Lili, ZHU Qiwei. Predictive value of plasma N-terminal pro-brain natriuretic peptide for prognosis in patients aged ≥80 years old with left ventricular hypertrophy [J]. Practical Geriatrics, 2024, 38(8): 797-801.
[14]	WANG Xinping, XIE Baimei, WEI Guo, YE Xiaoli, ZHAO Yayun, TAN Xiaotian. Expression levels and clinical significance of serum S100A9 and sCD163 in elderly patients with idiopathic interstitial pneumonia [J]. Practical Geriatrics, 2024, 38(8): 802-807.
[15]	LIU Meijuan, WANG Ning, WANG Dong, LU Fangzhou, LIU Juan. Effect of low-dose lidocaine combined with propofol on motor evoked potential in elderly patients undergoing intracranial tumor resection [J]. Practical Geriatrics, 2024, 38(8): 808-811.