肌肉质量,而不是数量,与结直肠癌手术后的结果有关
Marius Kemper1, Nathaniel Melling1, Linda Krause2
1Department of General, Visceral and Thoracic Surgery, Germany.
概括
通过肌肉辐射减弱 (MRA) 测量肌肉质量,预测结直肠癌手术后的结果更好. 对于识别可能从预康复中受益的高风险患者而言,MRA是比肌指数 (SMI) 更可靠的工具.
科学领域:
- 瘤外科手术 瘤外科手术
- 放射学 放射学是一门学科.
- 老年学是一门学科.
背景情况:
- 前期康复改善了接受结直肠癌手术的脱条件患者的结果.
- 鉴定肌肉状况不佳和术后风险高的患者至关重要,但具有挑战性.
- 骨肌肉指数 (SMI) 和肌肉辐射减弱 (MRA) 是风险分层的潜在工具.
研究的目的:
- 评估CT衍生的SMI (肌肉质量) 和MRA (肌肉质量) 对结直肠癌患者风险分层的潜力.
- 确定这些措施是否可以识别出最能从预康复中受益的患者.
主要方法:
- 对207名结直肠腺癌切除患者进行了回顾性,单中心的观察性研究.
- 收集的数据包括查尔森并发症指数 (CCI),术后并发症,停留时间和存活率.
- 使用多变量回归模型,根据临床和人口因素进行调整.
主要成果:
- 增加的MRA与手术后并发症 (解剖管泄漏,肺炎),不太严重的并发症 (Clavien-Dindo),更短的住院时间和延长的生存时间 (HR:0.63,p < 0.001) 相联系.
- 在SMI和术后结果或生存之间没有发现显著的关联.
- 与SMI相比,MRA在风险分层方面显示出更高的效用.
结论:
- 肌肉辐射减弱 (MRA) 是一种可靠的工具,用于识别在结直肠手术前肌肉状况不佳的高风险患者.
- 这些患者可能会从预康复干预中显著受益.
- 需要进一步的干预试验来证实基于MRA分层的预康复的好处.
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