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The evaluation of the association between preoperative sarcopenia and postoperative pneumonia and factors for preoperative sarcopenia in patients undergoing thoracoscopic-laparoscopic esophagectomy for esophageal cancer

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Abstract

Purpose

This study identified the relationship between postoperative pneumonia and preoperative sarcopenia as well as the factors for preoperative sarcopenia in patients with esophageal cancer.

Methods

In this retrospective, single-center, observational study, we evaluated the data of 274 patients who were scheduled for thoracoscopic-laparoscopic esophagectomy. Sarcopenia was defined using the skeletal muscle index, handgrip strength, and gait speed. The physical activity and nutritional status were evaluated. A multivariate logistic regression analysis was performed to confirm the association between sarcopenia and postoperative pneumonia and identify sarcopenia-related factors. A Spearman’s correlation analysis was used to identify the relationship between physical activity and nutritional status.

Results

Age, male sex, sarcopenia, and postoperative recurrent laryngeal nerve palsy were significantly associated with postoperative pneumonia. Age, male sex, physical activity, and nutritional status were significantly associated with preoperative sarcopenia. There was a significant correlation between physical activity and nutritional status.

Conclusions

Preoperative sarcopenia was confirmed to be a predictor of postoperative pneumonia. Furthermore, age, sex, physical activity, and nutritional status were significantly associated with preoperative sarcopenia. Physical activity and nutritional status are closely associated with each other in patients with esophageal cancer. A multidisciplinary approach to preoperative sarcopenia, taking exercise and nutrition into account, is recommended.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank the members of the Department of Musculoskeletal Oncology and Rehabilitation and Esophageal Surgery, National Cancer Center. This research would not have been possible without their leadership and cooperation.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan

    Takuya Fukushima, Noriko Watanabe, Yusuke Okita, Shota Yokota, Aiko Matsuoka, Kazuhiro Kojima & Akira Kawai

  2. Department of Esophageal Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan

    Daisuke Kurita, Koshiro Ishiyama, Junya Oguma & Hiroyuki Daiko

Authors
  1. Takuya Fukushima
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  2. Noriko Watanabe
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Corresponding author

Correspondence to Hiroyuki Daiko.

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Conflict of interest

Fukushima T, Watanabe N, Okita Y, Yokota S, Kojima K, Matsuoka A, Kurita D, Ishiyama K, Oguma J, Kawai A, and Daiko H declare that they have no conflicts of interest.

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Fukushima, T., Watanabe, N., Okita, Y. et al. The evaluation of the association between preoperative sarcopenia and postoperative pneumonia and factors for preoperative sarcopenia in patients undergoing thoracoscopic-laparoscopic esophagectomy for esophageal cancer. Surg Today 53, 782–790 (2023). https://doi.org/10.1007/s00595-022-02620-6

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