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Quick and simple; psoas density measurement is an independent predictor of anastomotic leak and other complications after colorectal resection.
Tech Coloproctol. 2019 Feb; 23(2):129-134.TC

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.

Authors+Show Affiliations

Division of Medical Sciences and Graduate Entry Medicine, Department of Surgery, University of Nottingham, Derby, UK. pherrod@nhs.net. Medical Research Council-Arthritis Research UK Centre for Musculoskeletal Ageing Research, Royal Derby Hospital, University of Nottingham, Derby, DE22 3DT, UK. pherrod@nhs.net.Division of Medical Sciences and Graduate Entry Medicine, Department of Surgery, University of Nottingham, Derby, UK.Division of Medical Sciences and Graduate Entry Medicine, Department of Surgery, University of Nottingham, Derby, UK.Combined Gastroenterology Research Unit, Scarborough General Hospital, Scarborough, UK.Division of Medical Sciences and Graduate Entry Medicine, Department of Surgery, University of Nottingham, Derby, UK.Division of Medical Sciences and Graduate Entry Medicine, Department of Surgery, University of Nottingham, Derby, UK.Division of Medical Sciences and Graduate Entry Medicine, Department of Surgery, University of Nottingham, Derby, UK.Division of Medical Sciences and Graduate Entry Medicine, Department of Surgery, University of Nottingham, Derby, UK.Division of Medical Sciences and Graduate Entry Medicine, Department of Surgery, University of Nottingham, Derby, UK.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

30790102

Citation

Herrod, P J J., et al. "Quick and Simple; Psoas Density Measurement Is an Independent Predictor of Anastomotic Leak and Other Complications After Colorectal Resection." Techniques in Coloproctology, vol. 23, no. 2, 2019, pp. 129-134.
Herrod PJJ, Boyd-Carson H, Doleman B, et al. Quick and simple; psoas density measurement is an independent predictor of anastomotic leak and other complications after colorectal resection. Tech Coloproctol. 2019;23(2):129-134.
Herrod, P. J. J., Boyd-Carson, H., Doleman, B., Trotter, J., Schlichtemeier, S., Sathanapally, G., Somerville, J., Williams, J. P., & Lund, J. N. (2019). Quick and simple; psoas density measurement is an independent predictor of anastomotic leak and other complications after colorectal resection. Techniques in Coloproctology, 23(2), 129-134. https://doi.org/10.1007/s10151-019-1928-0
Herrod PJJ, et al. Quick and Simple; Psoas Density Measurement Is an Independent Predictor of Anastomotic Leak and Other Complications After Colorectal Resection. Tech Coloproctol. 2019;23(2):129-134. PubMed PMID: 30790102.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Quick and simple; psoas density measurement is an independent predictor of anastomotic leak and other complications after colorectal resection. AU - Herrod,P J J, AU - Boyd-Carson,H, AU - Doleman,B, AU - Trotter,J, AU - Schlichtemeier,S, AU - Sathanapally,G, AU - Somerville,J, AU - Williams,J P, AU - Lund,J N, Y1 - 2019/02/21/ PY - 2018/09/07/received PY - 2019/01/17/accepted PY - 2019/2/23/pubmed PY - 2019/12/25/medline PY - 2019/2/22/entrez KW - Anastomotic leak KW - Colorectal neoplasms KW - Postoperative complications KW - Sarcopenia SP - 129 EP - 134 JF - Techniques in coloproctology JO - Tech Coloproctol VL - 23 IS - 2 N2 - 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. SN - 1128-045X UR - https://www.unboundmedicine.com/medline/citation/30790102/Quick_and_simple L2 - https://dx.doi.org/10.1007/s10151-019-1928-0 DB - PRIME DP - Unbound Medicine ER -