Effects Of Sarcopenia On Postoperative Complications Of Oesophagectomy Of Thoracic Oesophageal Squamous Cell Carcinoma

Objectives: Sarcopenia is closely associated with surgical complications of certain cancers.Here we assessed the relationship between sarcopenia and postoperative complications in patients with oesophageal squamous cell carcinoma.Methods: Retrospective analysis of patients who underwent thoracoscopic combined with laparoscopic radical resection of oesophageal cancer.Preoperative computed tomography to evaluate skeletal muscle mass to diagnose sarcopenia and patients were allocated into sarcopenia and non-sarcopenia groups to compared clinical characteristics between the two groups.The relationship between preoperative sarcopenia,age,body mass index(BMI),lung function,etc.and postoperative complications after minimally invasive oesophagectomy was also evaluated by using univariate?multivariate logistic regression.Results: Among 141 patients,including 29 women and 112 men,and the average age was 59.7±6.8 years.73 presented with sarcopenia(sarcopenia group)and 68 did not(non-sarcopenia group).The mean skeletal muscle index was 49.5 cm2/m2;median,49.3 cm2/m2;standard deviation,9.0 cm2/m2.The average SMI values for men and women were 51.4±8.7 cm2/m2 and 42.4 ± 6.6 cm2/m2,respectively.The proportion of men in the sarcopenia group was higher(P=0.039)and the BMI in that group was lower(P=0.001).There were no significant differences in other clinical and pathological features.The incidences of postoperative complications in the sarcopenia and non-sarcopenia groups were 63.0% and 38%,respectively(P = 0.002).The incidences of pulmonary infections and postoperative pleural effusions were 28.8% vs 11.8%(P = 0.01)and 38.4% vs 20.6%(P = 0.02)in the sarcopenia and non-sarcopenia groups,respectively.The incidences of other complications were not significantly different.Univariate and multivariate analyses of pulmonary infection-related clinical factors revealed that preoperative sarcopenia and forced expiratory volume(FEV1.0%)were independent risk factors for pulmonary infection after minimally invasive surgery.Conclusions: Preoperative sarcopenia was an independent risk factor for pulmonary infection after minimally invasive oesophagectomy.Identifying patients at risk of postoperative complications and providing perioperative care may help prevent postoperative pulmonary complications...