Cross-sectional areas of rectus abdominis and psoas muscles reduces following surgery in rectal cancer patients

• Published in: Supportive care in cancer Vol. 28; no. 5; pp. 2397 - 2405
• Main Authors: Yuksel, Oguz, Gezer, Naciye Sinem, Canda, Aras Emre, Celik, Hakki, Topcugil, Birsu, Benli, Merve Demir, Bisgin, Tayfun, Alicikus, Zumre Arican, Obuz, Funda
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.05.2020; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Cancer patients; Care and treatment; Chemoradiotherapy - adverse effects; Chemoradiotherapy - methods; Colorectal cancer; Comparative analysis; CT imaging; Female; Humans; Ileostomy - adverse effects; Ileostomy - methods; Laparoscopy; Laparoscopy - adverse effects; Laparoscopy - methods; Male; Meat products; Medicine; Medicine & Public Health; Middle Aged; Muscular Atrophy - physiopathology; Nursing; Nursing Research; Oncology; Original Article; Ostomy; Pain Medicine; Postoperative Period; Psoas Muscles - physiology; Rectal Neoplasms - diagnostic imaging; Rectal Neoplasms - surgery; Rectus Abdominis - physiology; Rehabilitation Medicine; Retrospective Studies; Surgery; Tomography, X-Ray Computed; Muscle atrophy; Psoas; Rectum resection surgery; Rectal cancer; Rectus abdominis
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-019-05062-y

Purpose To evaluate the trophic changes in rectus abdominis and psoas muscles in patients who underwent open or laparoscopic rectum resection for rectal cancer. Methods We retrospectively analyzed preoperative staging computerized tomographies (CT) and postoperative first oncological follow-up CTs of the patients who underwent low anterior resection (LAR) for rectal cancer from 2010 through 2015. We measured cross-sectional area of left and right rectus abdominis muscles from two levels (above and below umbilicus) where they are widest and psoas muscle at mid-level of the fourth lumbar vertebral body in axial CT images and compared preoperative and postoperative measurements. We investigated the effects of age, sex, administration of preoperative chemoradiotherapy (CRT), type of surgery (open or laparoscopic), or construction of a diverting ileostomy on cross-sectional muscle area changes. Results After applying inclusion and exclusion criteria 60 patients found to be eligible for the study. Muscle areas of all measurement sites were reduced postoperatively compared to paired preoperative values. There was no significant effect of age, sex, administration of preoperative CRT, type of surgery (open or laparoscopic), or construction of a diverting ileostomy to muscle cross-sectional area reductions. Conclusion Cross-sectional areas of the rectus abdominis and the psoas muscles of rectal cancer patients reduces following rectum resection which indicates atrophy of these muscles. Clinicians should be aware of this problem and focus on prevention of muscle atrophy during the treatment of rectal cancer patients.