COMBINING ASSESSMENT OF MUSCLE STRENGTH WITH MYOPENIA BETTER PREDICTS EARLY POSTOPERATIVE COMPLICATIONS AFTER...

Area of Science:

• Surgical Oncology
• Geriatric Medicine
• Clinical Nutrition

Background:

• Pancreaticoduodenectomy (PD) is a complex surgical procedure associated with substantial postoperative morbidity.
• Sarcopenia, the age-related loss of skeletal muscle mass and function, is increasingly recognized as a potential risk factor for adverse outcomes in surgical patients.

Purpose of the Study:

• To investigate the association between preoperative sarcopenia and postoperative complications following pancreaticoduodenectomy.
• To evaluate the diagnostic utility of comprehensive sarcopenia assessment methods in surgical patients.

Main Methods:

• A cohort of patients undergoing pancreaticoduodenectomy between July 2019 and December 2020 were assessed.
• Preoperative sarcopenia was evaluated using a combination of hand grip strength, Dual-energy X-ray absorptiometry (DEXA) for muscle quantity, and gait speed.
• Postoperative outcomes, including Clavien-Dindo complications and definition of DGE, were recorded and analyzed in relation to sarcopenia status.

Main Results:

• Of 36 patients included, 13.8% (n=5) were diagnosed with sarcopenia via comprehensive assessment, while 36.5% (n=13) had myopenia (low muscle mass) on DEXA alone.
• Patients with preoperative sarcopenia experienced significantly higher rates of major Clavien-Dindo complications (40% vs. 6.6%, P=0.04) and grade C postpancreatectomy diarrhea (40% vs. 0%, P=0.04).
• Myopenia alone, assessed by DEXA, did not show a significant correlation with increased postoperative complications (15.4% vs. 8.7%, P=0.66).

Conclusions:

• Comprehensive sarcopenia assessment, integrating muscle strength and quantity, is crucial for accurate diagnosis.
• Preoperative sarcopenia is identified as a significant independent risk factor for severe postoperative complications after pancreaticoduodenectomy.