Quick and simple; psoas density measurement is an independent predictor of anastomotic leak and other complications after colorectal resection
Background Radiologically defined sarcopenia has been shown to predict negative outcomes after cancer surgery, however radiological assessment of sarcopenia often requires additional software and standardisation against anthropomorphic data. Measuring psoas density using hospital Picture Archiving a...
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Published in | Techniques in coloproctology Vol. 23; no. 2; pp. 129 - 134 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Cham
Springer International Publishing
01.02.2019
Springer Nature B.V |
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Abstract | Background
Radiologically defined sarcopenia has been shown to predict negative outcomes after cancer surgery, however radiological assessment of sarcopenia often requires additional software and standardisation against anthropomorphic data. Measuring psoas density using hospital Picture Archiving and Communication Systems (PACS), universally available in the UK, may have advantages over methods requiring the use of additional specialist and often costly software. The aim of this study was to assess the association between radiologically defined sarcopenia measured by psoas density and postoperative outcome in patients having a colorectal cancer resection.
Methods
All patients having a resection for colorectal cancer, discussed by the colorectal multi-disciplinary team in one institution between 1/1/15 and 31/12/15, were retrospectively identified. Mean psoas density at the level of the L3 vertebra was analysed from preoperative computed tomography (CT) scans to define sarcopenia using the Picture Archiving and Communication Systems (PACS). Postoperative complications and mortality were recorded.
Results
One hundred and sixty-nine patients had a colorectal resection for cancer and 140 of these had a primary anastomosis. Ninety-day mortality and 1-year mortality were 1.1% and 7.1%, respectively. Eighteen (10.7%) patients suffered a Clavien–Dindo grade 3 or 4 complication of which 6 (33%) were anastomotic leaks. In the whole cohort, sarcopenia was associated with an increased risk of Clavien–Dindo grade 3 or 4 complications [adjusted OR 6.33 (1.65–24.23)
p
= 0.007]. In those who had an anastomosis, sarcopenia was associated with an increased risk of anastomotic leak [adjusted OR 14.37 (1.37–150.04)
p
= 0.026].
Conclusions
A quick and easy radiological assessment of sarcopenia by measuring psoas density on preoperative CT scan using software universally available in the UK is highly predictive of postoperative morbidity in colorectal cancer patients. |
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AbstractList | BACKGROUNDRadiologically defined sarcopenia has been shown to predict negative outcomes after cancer surgery, however radiological assessment of sarcopenia often requires additional software and standardisation against anthropomorphic data. Measuring psoas density using hospital Picture Archiving and Communication Systems (PACS), universally available in the UK, may have advantages over methods requiring the use of additional specialist and often costly software. The aim of this study was to assess the association between radiologically defined sarcopenia measured by psoas density and postoperative outcome in patients having a colorectal cancer resection. METHODSAll patients having a resection for colorectal cancer, discussed by the colorectal multi-disciplinary team in one institution between 1/1/15 and 31/12/15, were retrospectively identified. Mean psoas density at the level of the L3 vertebra was analysed from preoperative computed tomography (CT) scans to define sarcopenia using the Picture Archiving and Communication Systems (PACS). Postoperative complications and mortality were recorded. RESULTSOne hundred and sixty-nine patients had a colorectal resection for cancer and 140 of these had a primary anastomosis. Ninety-day mortality and 1-year mortality were 1.1% and 7.1%, respectively. Eighteen (10.7%) patients suffered a Clavien-Dindo grade 3 or 4 complication of which 6 (33%) were anastomotic leaks. In the whole cohort, sarcopenia was associated with an increased risk of Clavien-Dindo grade 3 or 4 complications [adjusted OR 6.33 (1.65-24.23) p = 0.007]. In those who had an anastomosis, sarcopenia was associated with an increased risk of anastomotic leak [adjusted OR 14.37 (1.37-150.04) p = 0.026]. CONCLUSIONSA quick and easy radiological assessment of sarcopenia by measuring psoas density on preoperative CT scan using software universally available in the UK is highly predictive of postoperative morbidity in colorectal cancer patients. Radiologically defined sarcopenia has been shown to predict negative outcomes after cancer surgery, however radiological assessment of sarcopenia often requires additional software and standardisation against anthropomorphic data. Measuring psoas density using hospital Picture Archiving and Communication Systems (PACS), universally available in the UK, may have advantages over methods requiring the use of additional specialist and often costly software. The aim of this study was to assess the association between radiologically defined sarcopenia measured by psoas density and postoperative outcome in patients having a colorectal cancer resection. All patients having a resection for colorectal cancer, discussed by the colorectal multi-disciplinary team in one institution between 1/1/15 and 31/12/15, were retrospectively identified. Mean psoas density at the level of the L3 vertebra was analysed from preoperative computed tomography (CT) scans to define sarcopenia using the Picture Archiving and Communication Systems (PACS). Postoperative complications and mortality were recorded. One hundred and sixty-nine patients had a colorectal resection for cancer and 140 of these had a primary anastomosis. Ninety-day mortality and 1-year mortality were 1.1% and 7.1%, respectively. Eighteen (10.7%) patients suffered a Clavien-Dindo grade 3 or 4 complication of which 6 (33%) were anastomotic leaks. In the whole cohort, sarcopenia was associated with an increased risk of Clavien-Dindo grade 3 or 4 complications [adjusted OR 6.33 (1.65-24.23) p = 0.007]. In those who had an anastomosis, sarcopenia was associated with an increased risk of anastomotic leak [adjusted OR 14.37 (1.37-150.04) p = 0.026]. A quick and easy radiological assessment of sarcopenia by measuring psoas density on preoperative CT scan using software universally available in the UK is highly predictive of postoperative morbidity in colorectal cancer patients. Background Radiologically defined sarcopenia has been shown to predict negative outcomes after cancer surgery, however radiological assessment of sarcopenia often requires additional software and standardisation against anthropomorphic data. Measuring psoas density using hospital Picture Archiving and Communication Systems (PACS), universally available in the UK, may have advantages over methods requiring the use of additional specialist and often costly software. The aim of this study was to assess the association between radiologically defined sarcopenia measured by psoas density and postoperative outcome in patients having a colorectal cancer resection. Methods All patients having a resection for colorectal cancer, discussed by the colorectal multi-disciplinary team in one institution between 1/1/15 and 31/12/15, were retrospectively identified. Mean psoas density at the level of the L3 vertebra was analysed from preoperative computed tomography (CT) scans to define sarcopenia using the Picture Archiving and Communication Systems (PACS). Postoperative complications and mortality were recorded. Results One hundred and sixty-nine patients had a colorectal resection for cancer and 140 of these had a primary anastomosis. Ninety-day mortality and 1-year mortality were 1.1% and 7.1%, respectively. Eighteen (10.7%) patients suffered a Clavien–Dindo grade 3 or 4 complication of which 6 (33%) were anastomotic leaks. In the whole cohort, sarcopenia was associated with an increased risk of Clavien–Dindo grade 3 or 4 complications [adjusted OR 6.33 (1.65–24.23) p = 0.007]. In those who had an anastomosis, sarcopenia was associated with an increased risk of anastomotic leak [adjusted OR 14.37 (1.37–150.04) p = 0.026]. Conclusions A quick and easy radiological assessment of sarcopenia by measuring psoas density on preoperative CT scan using software universally available in the UK is highly predictive of postoperative morbidity in colorectal cancer patients. |
Author | Lund, J. N. Williams, J. P. Schlichtemeier, S. Herrod, P. J. J. Boyd-Carson, H. Doleman, B. Trotter, J. Sathanapally, G. Somerville, J. |
Author_xml | – sequence: 1 givenname: P. J. J. orcidid: 0000-0002-6839-3897 surname: Herrod fullname: Herrod, P. J. J. email: pherrod@nhs.net organization: Division of Medical Sciences and Graduate Entry Medicine, Department of Surgery, University of Nottingham, Medical Research Council-Arthritis Research UK Centre for Musculoskeletal Ageing Research, Royal Derby Hospital, University of Nottingham – sequence: 2 givenname: H. surname: Boyd-Carson fullname: Boyd-Carson, H. organization: Division of Medical Sciences and Graduate Entry Medicine, Department of Surgery, University of Nottingham – sequence: 3 givenname: B. surname: Doleman fullname: Doleman, B. organization: Division of Medical Sciences and Graduate Entry Medicine, Department of Surgery, University of Nottingham – sequence: 4 givenname: J. surname: Trotter fullname: Trotter, J. organization: Combined Gastroenterology Research Unit, Scarborough General Hospital – sequence: 5 givenname: S. surname: Schlichtemeier fullname: Schlichtemeier, S. organization: Division of Medical Sciences and Graduate Entry Medicine, Department of Surgery, University of Nottingham – sequence: 6 givenname: G. surname: Sathanapally fullname: Sathanapally, G. organization: Division of Medical Sciences and Graduate Entry Medicine, Department of Surgery, University of Nottingham – sequence: 7 givenname: J. surname: Somerville fullname: Somerville, J. organization: Division of Medical Sciences and Graduate Entry Medicine, Department of Surgery, University of Nottingham – sequence: 8 givenname: J. P. surname: Williams fullname: Williams, J. P. organization: Division of Medical Sciences and Graduate Entry Medicine, Department of Surgery, University of Nottingham – sequence: 9 givenname: J. N. surname: Lund fullname: Lund, J. N. organization: Division of Medical Sciences and Graduate Entry Medicine, Department of Surgery, University of Nottingham |
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Keywords | Sarcopenia Colorectal neoplasms Anastomotic leak Postoperative complications |
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Radiologically defined sarcopenia has been shown to predict negative outcomes after cancer surgery, however radiological assessment of sarcopenia... Radiologically defined sarcopenia has been shown to predict negative outcomes after cancer surgery, however radiological assessment of sarcopenia often... BackgroundRadiologically defined sarcopenia has been shown to predict negative outcomes after cancer surgery, however radiological assessment of sarcopenia... BACKGROUNDRadiologically defined sarcopenia has been shown to predict negative outcomes after cancer surgery, however radiological assessment of sarcopenia... |
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SubjectTerms | Abdominal Surgery Aged Aged, 80 and over Anastomotic Leak - etiology Anastomotic Leak - mortality Colectomy - adverse effects Colorectal cancer Colorectal Neoplasms - complications Colorectal Neoplasms - diagnostic imaging Colorectal Neoplasms - surgery Colorectal Surgery Female Gastroenterology Humans Lumbar Vertebrae - diagnostic imaging Male Medicine Medicine & Public Health Middle Aged Mortality Original Original Article Postoperative Complications - etiology Postoperative Complications - mortality Predictive Value of Tests Preoperative Period Proctectomy - adverse effects Proctology Psoas Muscles - diagnostic imaging Psoas Muscles - pathology Retrospective Studies Sarcopenia Sarcopenia - diagnostic imaging Sarcopenia - etiology Sarcopenia - surgery Surgery Tomography, X-Ray Computed - statistics & numerical data |
Title | Quick and simple; psoas density measurement is an independent predictor of anastomotic leak and other complications after colorectal resection |
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