{"title":"结合肌力与肌萎缩的评估能更好地预测胰十二指肠切除术后早期并发症。","authors":"Saurabh Meshram, Santosh Irrinki, Vishal Sharma, Pankaj Gupta, Vikas Gupta, Thakur Deen Yadav, Rajesh Gupta, Harjeet Singh","doi":"10.1590/S0004-2803.24612024-136","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Pancreaticoduodenectomy (PD) is a complex procedure with significant postoperative morbidity. Associated sarcopenia could be a potential risk for increased post-operative complications.</p><p><strong>Methods: </strong>Patients who had undergone pancreaticoduodenectomy bet-ween July 2019 to December 2020 were included in the study. Preope-rative comprehensive sarcopenia assessment was done by hand grip strength test, Dual energy X-ray absorptiometry (DEXA) scan and gait speed test. Only myopenia was also assessed by DEXA scan in all the patients. Post-operative outcomes were recorded and the association of preoperative sarcopenia with postoperative complications were analyzed.</p><p><strong>Results: </strong>Of 47 patients assessed, 36 patients were finally included (Median age -58 years (IQR-51,68) years, 26 male). The five (13.8%) had sarcopenia confirmed on comprehensive assessment. Thirteen (36.5%) patients had myopenia on DEXA assessment. The major Clavien-Dindo complications were significantly higher in sarcopenia (40% vs 6.6%, P=0.04) and similarly, grade C DGE (40% vs 0, P=0.04) was also more frequent in patients with sarcopenia. The patients with myopenia only did not have a significant correlation with post-operative complications. (15.4% vs 8.7% P=0.66).</p><p><strong>Conclusion: </strong>Comprehensive assessment using muscle strength and muscle quantity is essential for sarcopenia diagnosis. Preoperative sarcopenia is a significant risk factor for post-operative complications.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"62 ","pages":"e24136"},"PeriodicalIF":0.0000,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435739/pdf/","citationCount":"0","resultStr":"{\"title\":\"COMBINING ASSESSMENT OF MUSCLE STRENGTH WITH MYOPENIA BETTER PREDICTS EARLY POSTOPERATIVE COMPLICATIONS AFTER PANCREATICODUODENECTOMY.\",\"authors\":\"Saurabh Meshram, Santosh Irrinki, Vishal Sharma, Pankaj Gupta, Vikas Gupta, Thakur Deen Yadav, Rajesh Gupta, Harjeet Singh\",\"doi\":\"10.1590/S0004-2803.24612024-136\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Pancreaticoduodenectomy (PD) is a complex procedure with significant postoperative morbidity. Associated sarcopenia could be a potential risk for increased post-operative complications.</p><p><strong>Methods: </strong>Patients who had undergone pancreaticoduodenectomy bet-ween July 2019 to December 2020 were included in the study. Preope-rative comprehensive sarcopenia assessment was done by hand grip strength test, Dual energy X-ray absorptiometry (DEXA) scan and gait speed test. Only myopenia was also assessed by DEXA scan in all the patients. Post-operative outcomes were recorded and the association of preoperative sarcopenia with postoperative complications were analyzed.</p><p><strong>Results: </strong>Of 47 patients assessed, 36 patients were finally included (Median age -58 years (IQR-51,68) years, 26 male). The five (13.8%) had sarcopenia confirmed on comprehensive assessment. Thirteen (36.5%) patients had myopenia on DEXA assessment. The major Clavien-Dindo complications were significantly higher in sarcopenia (40% vs 6.6%, P=0.04) and similarly, grade C DGE (40% vs 0, P=0.04) was also more frequent in patients with sarcopenia. The patients with myopenia only did not have a significant correlation with post-operative complications. (15.4% vs 8.7% P=0.66).</p><p><strong>Conclusion: </strong>Comprehensive assessment using muscle strength and muscle quantity is essential for sarcopenia diagnosis. Preoperative sarcopenia is a significant risk factor for post-operative complications.</p>\",\"PeriodicalId\":35671,\"journal\":{\"name\":\"Arquivos de Gastroenterologia\",\"volume\":\"62 \",\"pages\":\"e24136\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-09-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435739/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arquivos de Gastroenterologia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1590/S0004-2803.24612024-136\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arquivos de Gastroenterologia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1590/S0004-2803.24612024-136","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
背景：胰十二指肠切除术（PD）是一项复杂的手术，术后发病率高。相关的肌肉减少症可能是增加术后并发症的潜在风险。方法：将2019年7月至2020年12月期间行胰十二指肠切除术的患者纳入研究。术前通过手握力测试、双能x线吸收仪（DEXA）扫描和步态速度测试进行综合肌减少症评估。在所有患者中，DEXA扫描也只评估了肌萎缩。记录术后结果，分析术前肌肉减少与术后并发症的关系。结果：在评估的47例患者中，最终纳入36例患者（中位年龄-58岁（iqr -51,68）岁，男性26例）。5例（13.8%）经综合评价确诊为肌肉减少症。13例（36.5%）患者在DEXA评估中出现肌力低下。主要Clavien-Dindo并发症在肌肉减少症患者中明显更高（40% vs 6.6%， P=0.04），同样，C级DGE （40% vs 0， P=0.04）在肌肉减少症患者中也更常见。单纯肌萎缩患者与术后并发症无显著相关性。（15.4% vs 8.7% P=0.66）。结论：肌力、肌量综合评价是诊断肌少症的必要指标。术前肌肉减少症是术后并发症的重要危险因素。
COMBINING ASSESSMENT OF MUSCLE STRENGTH WITH MYOPENIA BETTER PREDICTS EARLY POSTOPERATIVE COMPLICATIONS AFTER PANCREATICODUODENECTOMY.
Background: Pancreaticoduodenectomy (PD) is a complex procedure with significant postoperative morbidity. Associated sarcopenia could be a potential risk for increased post-operative complications.
Methods: Patients who had undergone pancreaticoduodenectomy bet-ween July 2019 to December 2020 were included in the study. Preope-rative comprehensive sarcopenia assessment was done by hand grip strength test, Dual energy X-ray absorptiometry (DEXA) scan and gait speed test. Only myopenia was also assessed by DEXA scan in all the patients. Post-operative outcomes were recorded and the association of preoperative sarcopenia with postoperative complications were analyzed.
Results: Of 47 patients assessed, 36 patients were finally included (Median age -58 years (IQR-51,68) years, 26 male). The five (13.8%) had sarcopenia confirmed on comprehensive assessment. Thirteen (36.5%) patients had myopenia on DEXA assessment. The major Clavien-Dindo complications were significantly higher in sarcopenia (40% vs 6.6%, P=0.04) and similarly, grade C DGE (40% vs 0, P=0.04) was also more frequent in patients with sarcopenia. The patients with myopenia only did not have a significant correlation with post-operative complications. (15.4% vs 8.7% P=0.66).
Conclusion: Comprehensive assessment using muscle strength and muscle quantity is essential for sarcopenia diagnosis. Preoperative sarcopenia is a significant risk factor for post-operative complications.
期刊介绍：
The journal Arquivos de Gastroenterologia (Archives of Gastroenterology), a quarterly journal, is the Official Publication of the Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia IBEPEGE (Brazilian Institute for Studies and Research in Gastroenterology), Colégio Brasileiro de Cirurgia Digestiva - CBCD (Brazilian College of Digestive Surgery) and of the Sociedade Brasileira de Motilidade Digestiva - SBMD (Brazilian Digestive Motility Society). It is dedicated to the publishing of scientific papers by national and foreign researchers who are in agreement with the aim of the journal as well as with its editorial policies.
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