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Laparoscopic colorectal cancer surgery reduces the adverse impacts of sarcopenia on postoperative outcomes: a propensity score-matched analysis

  • Feng-Min Zhang
  • Bing-Wei Ma
  • Yang-Yang Huang
  • Wei-Zhe Chen
  • Jing-Juan Chen
  • Qian-Tong Dong
  • Wei-Sheng Chen
  • Xiao-Lei Chen
  • Xian Shen
  • Zhen Yu
  • Cheng-Le ZhuangEmail author
Article
  • 40 Downloads

Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

Laparoscopic surgery for colorectal cancer is a safe and feasible option with better short-term outcomes in patients with sarcopenia.

Keywords

Sarcopenia Laparoscopy Colorectal cancer Short-term outcome Propensity score 

Notes

Funding

This work was funded by the 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).

Compliance with ethical standards

Disclosures

Feng-Min Zhang, Bing-Wei Ma, Yang-Yang Huang, Wei-Zhe Chen, Jing-Juan Chen, Qian-Tong Dong, Wei-Sheng Chen, Xiao-Lei Chen, Xian Shen, Zhen Yu, and Cheng-Le Zhuang have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Feng-Min Zhang
    • 1
    • 3
  • Bing-Wei Ma
    • 2
  • Yang-Yang Huang
    • 5
  • Wei-Zhe Chen
    • 1
  • Jing-Juan Chen
    • 2
  • Qian-Tong Dong
    • 1
  • Wei-Sheng Chen
    • 1
  • Xiao-Lei Chen
    • 1
  • Xian Shen
    • 4
  • Zhen Yu
    • 2
  • Cheng-Le Zhuang
    • 1
    • 2
    Email author
  1. 1.Department of Gastrointestinal SurgeryThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
  2. 2.Department of Gastrointestinal SurgeryShanghai Tenth People’s Hospital Affiliated to TongJi UniversityShanghaiChina
  3. 3.The First Clinical Medical InstituteWenzhou Medical UniversityWenzhouChina
  4. 4.Department of Gastrointestinal SurgeryThe Second Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
  5. 5.Department of NeurologyShanghai Fourth People’s HospitalShanghaiChina

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