结直肠癌或胃癌手术后可能出现的肌肉减少和功能下降。

Naohiro Furuya, Junichi Ando, Hinata Murakami, Aoi Hashimoto, Yuki Takano, Daisuke Soma
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引用次数: 0

摘要

背景/目的:虽然可能的肌肉减少症可能影响胃肠道肿瘤手术后的短期预后,但其与出院时身体功能的关系仍不清楚。这项研究调查了术前可能的肌肉减少和出院时功能下降之间的关系。患者和方法:这项单中心回顾性队列研究纳入了2024年1月至2025年8月期间在埼玉关新海医院接受择期结直肠癌或胃癌切除术的200例连续患者。根据2025年亚洲肌少症工作组(AWGS 2025)标准定义可能的肌少症。放电时功能下降定义为从术前评估到放电时短物理性能电池(SPPB)总分下降≥1分。采用修正泊松回归估计相对危险度(rr)和95%置信区间(ci)。结果:200例患者中,54例(27.0%)可能出现肌肉减少症,37例(18.5%)出院时出现功能下降。54例患者中有19例(35.2%)可能出现肌肉减少,146例患者中有18例(12.3%)没有可能出现肌肉减少。在粗模型中,可能的肌肉减少与功能下降相关(RR=2.85, 95%CI=1.59-5.15; pp=0.006),在进一步调整体重指数、Charlson合病指数、肿瘤位置、手术方式和术前SPPB评分后(RR=2.15, 95%CI=1.09-4.25; p=0.027)。在年龄≥65岁的患者中也观察到类似的结果。结论:术前可能的肌肉减少与结直肠癌或胃癌切除术后出院时功能下降独立相关。握力评估可能是一种实用的术前筛查工具,用于识别有风险的患者,并规划围手术期康复或预康复。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Possible Sarcopenia and Functional Decline After Colorectal or Gastric Cancer Surgery.

Background/aim: While possible sarcopenia may influence short-term outcomes following gastrointestinal cancer surgery, its relationship with physical function at discharge remains poorly characterized. This study investigated the association between preoperative possible sarcopenia and functional decline at discharge.

Patients and methods: This single-center retrospective cohort study included 200 consecutive patients who underwent elective colorectal or gastric cancer resection at Saitama Sekishinkai Hospital between January 2024 and August 2025. Possible sarcopenia was defined according to the Asian Working Group for Sarcopenia 2025 (AWGS 2025) criteria. Functional decline at discharge was defined as a decrease of ≥1 point in the Short Physical Performance Battery (SPPB) total score from the preoperative assessment to discharge. Modified Poisson regression was used to estimate relative risks (RRs) and 95% confidence intervals (CIs).

Results: Of the 200 patients, 54 (27.0%) had possible sarcopenia and 37 (18.5%) showed functional decline at discharge. Functional decline occurred in 19 of 54 patients (35.2%) with possible sarcopenia and in 18 of 146 patients (12.3%) without possible sarcopenia. Possible sarcopenia was associated with functional decline in the crude model (RR=2.85, 95%CI=1.59-5.15; p<0.001), after adjustment for age and sex (RR=2.43, 95%CI=1.30-4.57; p=0.006), and after further adjustment for body mass index, Charlson Comorbidity Index, cancer location, surgical method, and preoperative SPPB scores (RR=2.15, 95%CI=1.09-4.25; p=0.027). Similar results were observed in patients aged ≥65 years.

Conclusion: Preoperative possible sarcopenia was independently associated with functional decline at discharge after colorectal or gastric cancer resection. Handgrip strength assessment may be a practical preoperative screening tool for identifying patients at risk and for planning perioperative rehabilitation or prehabilitation.

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