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The impact of sarcopenia on oncologic abdominal wall reconstruction
Author(s) -
Bailey Chad M.,
Schaverien Mark V.,
Garvey Patrick B.,
Liu Jessie,
Butler Charles E.,
Mericli Alexander F.
Publication year - 2020
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.26171
Subject(s) - sarcopenia , medicine , abdominal wall , multivariate analysis , clinical endpoint , hernia , logistic regression , surgery , randomized controlled trial
Background and Objectives Sarcopenia is an objective measure of patient frailty and is a predictor of adverse surgical outcomes. We hypothesized that sarcopenia is associated with increased surgical site occurrence (SSO) and hernia occurrences in patients undergoing oncologic abdominal wall reconstruction. Methods Consecutive patients who underwent abdominal wall reconstruction (AWR) for an abdominal wall ablative defect at a single center from 2005 to 2015 were evaluated. The total psoas index (TPI) was used to define sarcopenia. The primary endpoint of the study was hernia occurrence; (SSO) was a secondary outcome measure. Results Eighty‐six patients met the inclusion criteria. Multivariate analysis demonstrated that sarcopenia increased the risk of hernia more than threefold, trending toward significance (OR = 3.3; 95% CI: 0.69‐15.4; P = .13). Multivariate logistic regression demonstrated that preoperative radiotherapy (OR = 4.8, 95% CI: 1.4‐16; P = .01) and obesity (OR = 4.9, 95% CI: 1.5‐16.3; P =.009) were independent predictors of developing an SSO. Conclusions Sarcopenia, as defined by TPI, is correlated with hernia occurrence, but not SSO. These findings emphasize the importance of preoperative fitness and nutritional optimization and provide useful information for preoperative counseling and risk stratification.