Effects of body composition on early postoperative discharge and postoperative complications in patients with esophageal cancer.

Abstract

Patients with esophageal cancer are prone to nutrition deterioration during the perioperative period and have a high incidence of postoperative complications, prolonging hospitalization. Decreased muscle mass is a known contributor to this deterioration, but there is insufficient evidence on the effects of preoperative maintenance and improvement of muscle mass. In this study, we evaluated the relationship between body composition, early postoperative discharge, and postoperative complications in patients with esophageal cancer. This was a retrospective cohort study. Patients were divided into an early discharge group and a control group, who were discharged ≤21 days postoperatively and >21 days, respectively. The relationship of body composition to postoperative complications and discharge time in patients was evaluated via multivariate logistic regression using isotemporal substitution (IS) models. The early discharge group comprised 31 of the 117 patients (26%) included. This group had significantly lower incidences of sarcopenia and postoperative complications than the control group. In logistic regression analyses estimating the effect of changes in body composition using the IS models, preoperative replacement of 1 kg of body fat with 1 kg of muscle mass was associated with significantly higher odds of early discharge (odds ratio [OR], 1.28; 95% CI, 1.03-1.59) and lower odds of postoperative complications (OR, 0.81; 95% CI, 0.66-0.98). In patients with esophageal cancer, a preoperative increase in muscle mass may reduce postoperative complications and hospital stay duration.