Respiratory Sarcopenia Is Associated With Postoperative Pulmonary Complications in Patients With Esophageal Cancer.

IF 1.9 3区 医学 Q3 ONCOLOGY
Kakeru Hasegawa, Masahiko Wakasa, Kazuki Okura, Yusuke Takahashi, Yushi Nagaki, Yusuke Sato, Akiyuki Wakita, Yuji Kasukawa, Naohisa Miyakoshi
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Abstract

Esophagectomy for esophageal cancer carries a high risk of postoperative pulmonary complications (PPCs), which impact mortality and quality of life. Respiratory sarcopenia, characterized by decreased respiratory muscle strength and mass, may contribute to PPC risk, but its role remains unclear. This retrospective cohort study analyzed 79 patients who underwent esophagectomy (June 2021-June 2024). Respiratory sarcopenia was defined as the presence of both low maximum inspiratory pressure (MIP) and diaphragm thickness (DT), assessed using a respiratory pressure meter and ultrasound. PPCs were classified using the Clavien-Dindo grade > II. The incidence of PPCs was higher in patients with respiratory sarcopenia than those without (55% vs. 27%), based on unadjusted proportions. Bayesian logistic regression adjusting for age, smoking, and nutritional status showed that respiratory sarcopenia was strongly associated with PPCs (adjusted mean odds ratio: 2.79; 95% credible interval: 0.75-7.37), particularly pneumonia and prolonged hospitalization. Identifying and addressing respiratory sarcopenia preoperatively through inspiratory muscle training and nutritional support may reduce PPC risk and improve outcomes.

食管癌术后肺部并发症与呼吸性肌肉减少有关
食管癌的食管切除术有很高的术后肺部并发症(PPCs)风险,影响死亡率和生活质量。以呼吸肌肉力量和质量下降为特征的呼吸性肌肉减少症可能导致PPC风险,但其作用尚不清楚。这项回顾性队列研究分析了79例接受食管切除术的患者(2021年6月至2024年6月)。呼吸性肌肉减少症定义为最大吸气压力(MIP)和膈膜厚度(DT)均较低,使用呼吸压力计和超声进行评估。PPCs采用Clavien-Dindo分级> II进行分类。根据未调整的比例,呼吸性肌肉减少症患者的PPCs发生率高于无呼吸性肌肉减少症患者(55%对27%)。经年龄、吸烟和营养状况调整后的贝叶斯logistic回归显示,呼吸性肌肉减少症与PPCs密切相关(校正平均优势比:2.79;95%可信区间:0.75-7.37),尤其是肺炎和长期住院。术前通过吸气肌训练和营养支持识别和治疗呼吸性肌肉减少症可降低PPC风险并改善预后。
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来源期刊
CiteScore
4.70
自引率
4.00%
发文量
367
审稿时长
2 months
期刊介绍: The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.
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