The impact of properly diagnosed sarcopenia on postoperative outcomes after gastrointestinal surgery: A systematic review and meta-analysis

Abstract

Background Sarcopenia is defined as the loss of muscle mass combined with loss of muscle strength, with or without loss of muscle performance. The use of this parameter as a risk factor for complications after surgery is not currently used. This meta-analysis aims to assess the impact of sarcopenia defined by radiologically and clinically criteria and its relationship with complications after gastrointestinal surgeries. Materials and methods A review of the literature was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO registration number: CRD42019132221). Articles were selected from the PUBMED and EMBASE databases that adequately assessed sarcopenia and its impact on postoperative complications in gastrointestinal surgery patients. Pooled estimates of pre-operative outcome data were calculated using the odds ratio (OR) and 95% confidence interval (CI). Subgroup analysis were performed to assess each type of surgery. Results The search strategy returned 1323, with 11 studies meeting the inclusion criteria. A total of 4265 patients were analysed. The prevalence of sarcopenia between studies ranged from 6.8% to 35.9%. The meta-analysis showed an OR for complications after surgery of 3.01 (95% CI 2.55-3.55) and an OR of 2.2 (95% CI 1.44-3.36) for hospital readmission (30 days).

The Role of Visceral Obesity, Sarcopenia and Sarcopenic Obesity on Surgical Outcomes After Liver Resections for Colorectal Metastases

“…A significantly higher risk for postoperative complications was found in emergency surgery (RR = 2.07, 4 studies, 734 patients [ 29 ]) and in surgery for inflammatory bowel disease (OR = 6.097, 10 studies, 885 patients [ 30 ]). The morbidity was also increased after gastrectomy (OR 3.09, 8 studies, 2649 patients [ 31 ]) and after colorectal resections (OR 2.71, 2 studies, 518 patients [ 31 ] but a higher risk of postoperative complications has not been identified after esophageal (OR 0.81, 8 studies, 1488 patients [ 32 ]) and pancreatic resections (13 studies, 3608 patients [ 33 ]). All commonly used CT-assessed sarcopenia indexes, such as the skeletal muscle index (SMI), predict the risk of major postoperative complications (RR 1.36, 22 studies, 6656 patients [ 34 ]).…”

The Prevalence of Sarcopenia and Its Impact on Clinical Outcomes in Lumbar Degenerative Spine Disease—A Systematic Review and Meta-Analysis

“…Sarcopenia has been reported to be associated with adverse post-surgical outcomes in many medication conditions. In 2020, a meta-analysis reported an elevated risk of complications and readmissions in patients with sarcopenia after any type of gastrointestinal surgery [ 39 ]. Similarly, another meta-analysis pointed out that sarcopenia independently predicted shorter survival and increased mortality among patients undergoing urologic oncology surgeries [ 40 ].…”

Treating incarcerated inguinal hernias with TEP is a viable option for experienced surgeons

“…Mitura et al 26 observed that the occurrence and intensity of pain was significantly higher in younger patients. Other characteristics may play a role, not only in pain, but also morbidity and mortality, this include smoking 27 , previous intestinal resection 28 and concomitant diseases 28 , 29 .…”