Значение саркопении в развитии послеоперационных осложнений у пациентов, перенесших резекционные вмешательства на поджелудочной железе

Abstract

The aim of the research. To evaluate the effect of sarcopenia on the incidence of postoperative complications in patients who underwent resection interventions on the pancreas, as well as the development of a simple clinical diagnosis of sarcopenia. Material and methods. Th e study included 109 patients, including 59 (54.1 %) men and 50 (45.9 %) women. All patients included in the study were operated on with subsequent morphological examination of the removed preparations. Diagnosis of the presence of sarcopenia in a patient was carried out using computed tomography (CT) and calculating the musculoskeletal index. Also, all patients underwent calculation of the psoas major muscle index (IBPM) equal to the ratio of the area of the psoas major muscle on one side to the square of the patient’s height. Th e patients were divided into two groups. The control group (68 patients) included patients without sarcopenia. The main group consisted of 41 patients who were diagnosed with sarcopenia. Results. Among patients in the compared groups, there were no statistically signifi cant diff erences in age, sex, ASA score and body mass index. Th ere was no statistically signifi cant diff erence in the incidence of major complications (Clavien-Dindo III / IV) (p = 0.2), however, the incidence of postoperative infectious complications was signifi cantly higher in patients from the study group compared to the control group (63.4 % versus 39.7 %, respectively, p = 0.01), as well as the incidence of postoperative clinically signifi cant pancreatic fi stulas (36.6 % versus 17.6 %, respectively, p = 0.02), as well as mortality (9.8 % versus 1.5 %, respectively, p = 0.04). The average postoperative bed-day was 19.9±7.8 days in the main group, 14.2±5.1 days in the control group (p = 0.03). According to the study, the value of IBP in the diagnosis of sarcopenia is < 3,5 сm2 /м2 (AUC – 0,83) for men and < 2,7 сm2 /м2 (AUC – 0,87) for women. Conclusion. Sarcopenia is associated with a higher incidence of postoperative infectious complications, clinically signifi cant pancreatic fi stulas, mortality, as well as with a longer postoperative bed-day in patients who underwent resection of the pancreas