Malnutrition and sarcopenia versus complications following Esophagectomy, Gastrectomy and HIPEC

Rasul, B. (Baktash) (2016) Malnutrition and sarcopenia versus complications following Esophagectomy, Gastrectomy and HIPEC. thesis, Medicine.

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Abstract

Background and objectives: Malnutrition and skeletal muscle depletion (sarcopenia) are frequently seen in patients with gastrointestinal malignancies and both enhance the postoperative complications like (anastomotic) leakage, infections and pneumonia in oncological patients. Both malnutrition and sarcopenia are associated with an altered inflammatory status. The aim of this study was to investigate whether malnutrition and sarcopenia are risk factors for postoperative complications in patients undergoing curative resection for esophageal/gastric cancer and patients with peritoneal surface malignancies undergoing a peritonectomy and HIPEC. Methods: In this retrospective study the data from the DUCA (Dutch Upper GI Cancer Audit), the esophageal database and HIPEC database of the department of abdominal surgery of the UMCG (University Medical Center Groningen) from January 2014 through December 2014 were collected and reviewed. Skeletal muscle mass was assessed using preoperative computed tomographic scans by measuring the cross-sectional muscle area at the third lumbar vertebral level. Results: From a total of 91 patients, 79 patients were included and 12 patients excluded. The majority of the patients who underwent curative resection for esophageal and gastric cancer and peritoneal surface malignancies were sarcopenic (81%, n = 26/33; 81%, n = 17/29 and 65%, n = 17/29 respectively), based on previously determined sex-specific cut-off values (52.4 cm2/m2 for men and 38.5 cm2/m2 for women). 21 esophageal cancer patients, 9 peritoneal surface malignancy patients and 9 gastric cancer patients with postoperative complications were sarcopenic (81% p = 0,47; 53% p = 0,11; 56% p = 0,82, respectively). Most of the esophageal cancer patients with MUST score ≥ 2 (91%) had postoperative complications (n = 10 out 11, p = 0,04). There was no significant association between MUST score ≥ 2 and postoperative complications in peritoneal surface malignancies and gastric cancer patients (p = 0,38 and p = 0,46 respectively). Conclusions: Sarcopenia is not a risk factor for postoperative complications in patients undergoing curative resection for esophageal/gastric cancer and patients with peritoneal surface malignancies undergoing a peritonectomy and HIPEC. Malnutrition is a risk factor for postoperative complications in patients undergoing curative resection for esophageal cancer but not in patients with peritoneal surface malignancies undergoing a peritonectomy and HIPEC and in patients with gastric cancer undergoing curative resection.

Item Type:	Thesis (Thesis)
Supervisor name:	Naam begeleider: and Haveman Dr. J.W. (chirurg) and Naam 2e begeleider: Leeuwen Dr. B.I. van (chirurg) and Instelling: Universitair Medisch Centrum Groningen
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:39
Last Modified:	25 Jun 2020 10:39
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/111

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