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Bajawi M, Corral S, Blázquez J, Die J, Muñoz P, Barranquero AG, Juez L, Nisa FGM. Impact of CT-measured sarcopenic obesity on postoperative outcomes following colon cancer surgery. Langenbecks Arch Surg 2024; 409:42. [PMID: 38231409 PMCID: PMC10794372 DOI: 10.1007/s00423-024-03231-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 01/03/2024] [Indexed: 01/18/2024]
Abstract
OBJECTIVE This study aimed to investigate the influence of sarcopenic obesity on anastomotic leak following elective colon resection for non-metastatic colon cancer. Secondary outcomes included overall morbidity, mortality and length of hospital stay. METHODS This retrospective observational study, conducted at a colorectal surgery referral centre, spanned from January 1, 2015, to January 1, 2020. A total of 544 consecutive patients who underwent elective colon resection were included in the analysis, excluding patients with rectal cancer, urgent surgery, absence of anastomosis, lack of imaging, multivisceral resections and synchronic tumours. RESULTS Postoperative complications were observed in 177 (32.3%) patients, with 51 (9.31%) classified as severe (Clavien-Dindo > II). Sarcopenic obesity was identified in 9.39% of the sample and emerged as an independent predictor of increased overall morbidity [OR 2.15 (1.14-3.69); p = 0.016] and 30-day mortality [OR 5.07 (1.22-20.93); p = 0.03] and was significantly associated with the development of anastomotic leak [OR 2.95 (1.41-6.18); p = 0.007]. Furthermore, it increased the risk of reoperation and was linked to a prolonged length of hospital stay. CONCLUSIONS CT-measured sarcopenic obesity demonstrates a discernible correlation with an elevated risk of postoperative morbidity and mortality in the context of colon cancer surgery.
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Affiliation(s)
| | - Sara Corral
- Department of General Surgery, Ramón y Cajal University Hospital, Madrid, Spain
| | - Javier Blázquez
- Department of Radiology, Ramón y Cajal University Hospital, Madrid, Spain
| | - Javier Die
- Department of General Surgery, Ramón y Cajal University Hospital, Madrid, Spain
| | - Paula Muñoz
- Department of General Surgery, Ramón y Cajal University Hospital, Madrid, Spain
| | | | - Luz Juez
- Department of General Surgery, Ramón y Cajal University Hospital, Madrid, Spain
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Juez LD, Priego P, Bajawi M, Cuadrado M, Blázquez LA, Sánchez-Picot S, Galindo J, Blázquez J, Fernández-Cebrián JM, Botella-Carretero JI. Impact of Sarcopenic Obesity on Long-Term Cancer Outcomes and Postoperative Complications After Gastrectomy for Gastric Cancer. J Gastrointest Surg 2023; 27:35-46. [PMID: 36324039 DOI: 10.1007/s11605-022-05492-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 09/20/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND The prevalence of sarcopenia in gastric cancer (GC), although varying among the reported studies, is around 60%. In the last few years, it has been recognised that sarcopenia can also occur not only in patients with weight loss and low body weight, but also in patients with normal or increased body mass index. Therefore, the term sarcopenic obesity (SO) is a new definition that further expands the implications of altered body composition. The aim of this study was to assess the impact of SO on the perioperative morbidity and the survival of GC patients undergoing gastrectomy by evaluating body composition on CT images. METHODS Preoperative CT scans were obtained from all patients with a diagnosis of GC undergoing gastrectomy with curative intent between January 2012 and December 2019. Skeletal muscle mass index (SMMI) and visceral adipose tissue (VAT) cross-sectional area at the level of the transverse processes of the third lumbar vertebra (L3) were measured. Sarcopenia and obesity were defined according to sex-specific cut-off points. RESULTS After analysing 190 patients, the prevalence of SO was 21.1% (40 patients) and sarcopenia was 14.7% (28 patients). Multivariate analysis showed that corporal composition was an independent factor of overall survival (p = 0.049). Logistic regression was performed to identify risk factors associated with postoperative complications. SO was identified as a risk factor for serious Clavien-Dindo complications > IIIb/IV [OR 2.82 (1.1-7.1); p = 0.028]. CONCLUSION SO was a risk factor for severe postoperative complications as well as worse long-term oncological after a gastrectomy for GC.
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Affiliation(s)
- Luz Divina Juez
- Division of Esophagogastric and Bariatric Surgery, Department of General and Digestive Surgery, Facultad de Medicina, Hospital Universitario Ramón Y Cajal, Universidad de Alcalá, IRYCIS, Ctra. Colmenar Viejo, Km 9.100-28034, Madrid, Spain
| | - Pablo Priego
- Division of Esophagogastric and Bariatric Surgery, Department of General and Digestive Surgery, Facultad de Medicina, Hospital Universitario Ramón Y Cajal, Universidad de Alcalá, IRYCIS, Ctra. Colmenar Viejo, Km 9.100-28034, Madrid, Spain.
| | - Mariam Bajawi
- Division of Esophagogastric and Bariatric Surgery, Department of General and Digestive Surgery, Facultad de Medicina, Hospital Universitario Ramón Y Cajal, Universidad de Alcalá, IRYCIS, Ctra. Colmenar Viejo, Km 9.100-28034, Madrid, Spain
| | - Marta Cuadrado
- Division of Esophagogastric and Bariatric Surgery, Department of General and Digestive Surgery, Facultad de Medicina, Hospital Universitario Ramón Y Cajal, Universidad de Alcalá, IRYCIS, Ctra. Colmenar Viejo, Km 9.100-28034, Madrid, Spain
| | - Luis A Blázquez
- Division of Esophagogastric and Bariatric Surgery, Department of General and Digestive Surgery, Facultad de Medicina, Hospital Universitario Ramón Y Cajal, Universidad de Alcalá, IRYCIS, Ctra. Colmenar Viejo, Km 9.100-28034, Madrid, Spain
| | - Silvia Sánchez-Picot
- Division of Esophagogastric and Bariatric Surgery, Department of General and Digestive Surgery, Facultad de Medicina, Hospital Universitario Ramón Y Cajal, Universidad de Alcalá, IRYCIS, Ctra. Colmenar Viejo, Km 9.100-28034, Madrid, Spain
| | - Julio Galindo
- Division of Esophagogastric and Bariatric Surgery, Department of General and Digestive Surgery, Facultad de Medicina, Hospital Universitario Ramón Y Cajal, Universidad de Alcalá, IRYCIS, Ctra. Colmenar Viejo, Km 9.100-28034, Madrid, Spain
| | - Javier Blázquez
- Department of Radiology, Facultad de Medicina, Hospital Universitario Ramón Y Cajal, Universidad de Alcalá, IRYCIS, Madrid, Spain
| | - José María Fernández-Cebrián
- Division of Esophagogastric and Bariatric Surgery, Department of General and Digestive Surgery, Facultad de Medicina, Hospital Universitario Ramón Y Cajal, Universidad de Alcalá, IRYCIS, Ctra. Colmenar Viejo, Km 9.100-28034, Madrid, Spain
| | - Jose I Botella-Carretero
- Department of Endocrinology and Nutrition, Facultad de Medicina, Hospital Universitario Ramón Y Cajal, Universidad de Alcalá, IRYCIS, Madrid, Spain
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Barranquero AG, Priego P, Muñoz P, Bajawi M, Cuadrado M, Blázquez L, Sánchez-Picot S, Galindo J, Fernández-Cebrián JM. Laparoscopic vs. Open Gastrectomy for Advanced Gastric Cancer in a Western Population: a Propensity-Score Matched Analysis of Surgical and Oncological Results. Indian J Surg 2022. [DOI: 10.1007/s12262-022-03291-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Puerta A, Bajawi M, Abadía P, Vilar A, Die J. Hysterectomy, bilateral salpingo-oophorectomy and total colectomy for Lynch syndrome - hybrid natural orifice transluminal endoscopic surgery - a video vignette. Colorectal Dis 2020; 22:2357-2358. [PMID: 32920980 DOI: 10.1111/codi.15362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 09/02/2020] [Indexed: 02/08/2023]
Affiliation(s)
- A Puerta
- Colorectal Surgery Department, Ramón y Cajal University Hospital, Madrid, Spain
| | - M Bajawi
- Colorectal Surgery Department, Ramón y Cajal University Hospital, Madrid, Spain
| | - P Abadía
- Colorectal Surgery Department, Ramón y Cajal University Hospital, Madrid, Spain
| | - A Vilar
- Colorectal Surgery Department, Ramón y Cajal University Hospital, Madrid, Spain
| | - J Die
- Colorectal Surgery Department, Ramón y Cajal University Hospital, Madrid, Spain
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Vilar Tabanera A, Bajawi M, Abadía P, Puerta Vicente A, Ballestero A, Ramos D, Moreno I, Pina JD, Die J. Ureteric localization with indocyanine green fluorescence during low anterior resection - a video vignette. Colorectal Dis 2020; 22:1769. [PMID: 32470216 DOI: 10.1111/codi.15158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 05/10/2020] [Indexed: 02/08/2023]
Affiliation(s)
- A Vilar Tabanera
- General Surgery Department, Ramón y Cajal University Hospital, Madrid, Spain
| | - M Bajawi
- General Surgery Department, Ramón y Cajal University Hospital, Madrid, Spain
| | - P Abadía
- General Surgery Department, Ramón y Cajal University Hospital, Madrid, Spain
| | - A Puerta Vicente
- General Surgery Department, Ramón y Cajal University Hospital, Madrid, Spain
| | - A Ballestero
- General Surgery Department, Ramón y Cajal University Hospital, Madrid, Spain
| | - D Ramos
- General Surgery Department, Ramón y Cajal University Hospital, Madrid, Spain
| | - I Moreno
- General Surgery Department, Ramón y Cajal University Hospital, Madrid, Spain
| | - J D Pina
- General Surgery Department, Ramón y Cajal University Hospital, Madrid, Spain
| | - J Die
- General Surgery Department, Ramón y Cajal University Hospital, Madrid, Spain
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Vilar Tabanera A, Bajawi M, Vidal Mondejar J, García Perez JC. Inferior epigastric artery pseudoaneurysm: Complication of surgical drain insertion. Cir Esp 2020. [PMID: 32912622 DOI: 10.1016/j.ciresp.2020.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Alberto Vilar Tabanera
- Departamento de Coloproctología del Hospital Universitario Ramón y Cajal, Madrid, España.
| | - Mariam Bajawi
- Departamento de Coloproctología del Hospital Universitario Ramón y Cajal, Madrid, España
| | - Jaime Vidal Mondejar
- Departamento de Radiología del Hospital Universitario Ramón y Cajal, Madrid, España
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