机构：[1]Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China[2]Department of Gastrointestinal Surgery, Shanghai Tenth People’s Hospital Affiliated to TongJi University, 301 Yanchang Road, Shanghai 200072, China[3]The First Clinical Medical Institute, Wenzhou Medical University, Wenzhou, China[4]Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China[5]Department of Neurology, Shanghai Fourth People’s Hospital, North 1878 Sichuan Road, Shanghai, China
Sarcopenia is a negative predictor for postoperative recovery. This study was performed to evaluate the short-term outcomes of laparoscopic surgery in colorectal cancer patients with sarcopenia.
We conducted a study of patients who underwent curative surgeries for colorectal cancer in two centers from July 2014 to July 2018. In order to reduce selection bias, we conducted a propensity score matching analysis. Preoperative characteristics including age, gender, anemia, body mass index, hypoalbuminemia, America society of anesthesiology scores, epidural anesthesia, operative procedure, stoma, tumor location, and combined resection were incorporated in the model, and produced 58 matched pairs. The third lumbar skeletal muscle mass, handgrip strength, and 6 m usual gait speed were measured to define sarcopenia. Short-term outcomes were compared between the two groups.
In a total of 1136 patients, 272 had sarcopenia diagnosed, and 227 were further analyzed in this study. Among them, 108 patients underwent laparoscopic colorectal surgery and 119 underwent open colorectal surgery. In the matched cohort, the clinical characteristics of the two groups were well matched. The laparoscopic group had significantly reduced overall complications (15.5% vs. 36.2%, P = 0.016) and shorter postoperative hospital stays (10.5 vs. 14, P = 0.027). Subgroup analysis of postoperative complications showed that the incidence of surgical complications (P = 0.032) was lower in the laparoscopic group. Hospitalization costs (P = 0.071) and 30-day readmissions (P = 0.215) were similar between the two groups.
Laparoscopic surgery for colorectal cancer is a safe and feasible option with better short-term outcomes in patients with sarcopenia.
基金：
National Natural Science
Foundation of China (Nos. 81800795, 81770884), Shanghai Municipal
Commission of Health and Family Planning (No. 20184Y0301),
Shanghai Science and Technology Committee (No. 16411954200), the
Fundamental Research Funds for the Central Universities and the foundation
of the Health Department of Zhejiang province (2016DTA006).
语种：
外文
PubmedID：
中科院(CAS)分区：
出版当年[2020]版：
大类|2 区医学
小类|2 区外科
最新[2023]版：
大类|2 区医学
小类|2 区外科
第一作者：
第一作者机构：[1]Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China[3]The First Clinical Medical Institute, Wenzhou Medical University, Wenzhou, China
通讯作者：
通讯机构：[1]Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China[2]Department of Gastrointestinal Surgery, Shanghai Tenth People’s Hospital Affiliated to TongJi University, 301 Yanchang Road, Shanghai 200072, China
推荐引用方式(GB/T 7714)：
Feng‑Min Zhang,Bing‑Wei Ma,Yang‑Yang Huang,et al.Laparoscopic colorectal cancer surgery reduces the adverse impacts of sarcopenia on postoperative outcomes: a propensity score-matched analysis.[J].Surgical endoscopy.2020,34(10):4582-4592.doi:10.1007/s00464-019-07249-0.
APA：
Feng‑Min Zhang,Bing‑Wei Ma,Yang‑Yang Huang,Wei‑Zhe Chen,Jing‑Juan Chen...&Cheng‑Le Zhuang.(2020).Laparoscopic colorectal cancer surgery reduces the adverse impacts of sarcopenia on postoperative outcomes: a propensity score-matched analysis..Surgical endoscopy,34,(10)
MLA：
Feng‑Min Zhang,et al."Laparoscopic colorectal cancer surgery reduces the adverse impacts of sarcopenia on postoperative outcomes: a propensity score-matched analysis.".Surgical endoscopy 34..10(2020):4582-4592
医学