Relation between Sarcopenia and Surgical Site Infection in Patients Undergoing Gastric Cancer Surgery

Ölmez, Tolga; Gülmez, Şelçuk; Karakose, Erdal; Ofluoglu, Cem Batuhan; Senger, Aziz Serkan; Bozkurt, Hilmi; Duman, Mustafa; Polat, Erdal

doi:10.1089/sur.2020.211

Cited by 11 publications

(9 citation statements)

References 16 publications

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“…Currently, surgical treatment remains the most effective method among all clinical approaches, with surgical options for gastric cancer primarily including open radical gastrectomy, laparoscopic‐assisted radical gastrectomy, total laparoscopic radical gastrectomy, and robot‐assisted radical gastrectomy 42–46 . However, evidence suggests that postoperative prognosis remains grim, with complications such as postoperative bleeding, surgical site infections, slow recovery and severe concurrent complications posing significant threats to patient safety 47,48 . In this context, the ERAS concept has emerged, employing a multidisciplinary collaboration in clinical, nutritional, nursing and anaesthetic care to optimize perioperative measures, reduce surgical stress, enhance functional recovery, minimize complications, and shorten hospital stays 49 …”

Section: Discussionmentioning

confidence: 99%

“…[42][43][44][45][46] However, evidence suggests that postoperative prognosis remains grim, with complications such as postoperative bleeding, surgical site infections, slow recovery and severe concurrent complications posing significant threats to patient safety. 47,48 In this context, the ERAS concept has emerged, employing a multidisciplinary collaboration in clinical, nutritional, nursing and anaesthetic care to optimize perioperative measures, reduce surgical stress, enhance functional recovery, minimize complications, and shorten hospital stays. 49 Surgical site wound infection is a common complication in gastric cancer surgery.…”

Section: Discussionmentioning

confidence: 99%

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Effects of enhanced recovery after surgery nursing program on the surgical site wound infection and postoperative complications in patients of gastric cancer: A meta‐analysis

Sun,

Li,

Cao

et al. 2024

International Wound Journal

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This meta‐analysis systematically evaluates the impact of the enhanced recovery after surgery (ERAS) concept on surgical site wound infections and postoperative complications in gastric cancer patients. A comprehensive computerized search was conducted in PubMed, Embase, Google Scholar, Cochrane Library, China National Knowledge Infrastructure and Wanfang databases for randomized controlled trials (RCTs), from database inception to November 2023, exploring the application of the ERAS concept in the perioperative period of gastric cancer surgery. Two researchers independently screened the literature, extracted data, and conducted quality assessments based on inclusion and exclusion criteria. Data analysis was performed using Stata 17.0 software. A total of 24 RCTs involving 2050 gastric cancer patients were included. The analysis revealed a significantly lower incidence of wound infections (OR = 0.23, 95% CI: 0.14–0.40, p < 0.001) and postoperative complications (OR = 0.20, 95% CI: 0.15–0.27, p < 0.001) in the ERAS group compared to the standard care group. This study demonstrates that the application of the ERAS concept during the perioperative period in gastric cancer surgery can effectively reduce the occurrence of wound infections and complications, thereby facilitating postoperative recovery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effects of enhanced recovery after surgery nursing program on the surgical site wound infection and postoperative complications in patients of gastric cancer: A meta‐analysis

Sun,

Li,

Cao

et al. 2024

International Wound Journal

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“…The present study sheds light on the underestimated value of CT information in patient care. Preoperatively, body composition determination can be used to predict short‐term surgical outcomes, including operation times, 29 bleeding, 30 number of retrieved lymph nodes, 31 surgical site infections, 32 , 33 and major complications, 28 , 34 which are associated with body shape. 35 , 36 This information may be used to select the type of operative approach, such as open, laparoscopic, or robot‐assisted, during subsequent procedures.…”

Section: Discussionmentioning

confidence: 99%

Detection of sarcopenic obesity and prediction of long‐term survival in patients with gastric cancer using preoperative computed tomography and machine learning

Kim

Han

Kim

2021

Journal of Surgical Oncology

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Background: Previous studies evaluating the prognostic value of computed tomography (CT)-derived body composition data have included few patients. Thus, we assessed the prevalence and prognostic value of sarcopenic obesity in a large population of gastric cancer patients using preoperative CT, as nutritional status is a predictor of long-term survival after gastric cancer surgery. Methods: Preoperative CT images were analyzed for 840 gastric cancer patients who underwent gastrectomy between March 2009 and June 2018. Machine learning algorithms were used to automatically detect the third lumbar (L3) vertebral level and segment the body composition. Visceral fat area and skeletal muscle index at L3 were determined and used to classify patients into obesity, sarcopenia, or sarcopenic obesity groups.Results: Out of 840 patients (mean age = 60.4 years; 526 [62.6%] men), 534 (63.5%) had visceral obesity, 119 (14.2%) had sarcopenia, and 48 (5.7%) patients had sarcopenic obesity. Patients with sarcopenic obesity had a poorer prognosis than those without sarcopenia (hazard ratio [HR] = 3.325; 95% confidence interval [CI] = 1.698-6.508). Multivariate analysis identified sarcopenic obesity as an independent risk factor for increased mortality (HR = 2.608; 95% CI = 1.313-5.179).

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“…Among the included studies, twenty-four studies were retrospective, and two studies were prospective. The diagnoses included gastric cancer (n = 1,980) (14,16,17,28,34), esophageal cancer (n = 296) (18, 20, 36), hepatic cancer (n = 535) (23,24), pancreatic cancer (n = 1,160) (15,25,26,(31)(32)(33), colorectal cancer (n = 4,328), (19,21,22,27,29,30,35,37) and colorectal liver metastases (n = 430) (38,39). The pooled average age of 5,784 patients was 65.6 (95% CI: 63.7-67.6) years (14-16, 18-21, 23-27, 30-33, 35-39).…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Sarcopenic obesity and therapeutic outcomes in gastrointestinal surgical oncology: A meta-analysis

Wang

et al. 2022

Front. Nutr.

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BackgroundSarcopenic obesity (SO) has been indicated as a scientific and clinical priority in oncology. This meta-analysis aimed to investigate the impacts of preoperative SO on therapeutic outcomes in gastrointestinal surgical oncology.MethodsWe searched the PubMed, EMBASE, and Cochrane Library databases through March 4th 2022 to identify cohort studies. Endpoints included postoperative complications and survival outcomes. Newcastle Ottawa Scale was used for quality assessment. Heterogeneity and publication bias were assessed. Subgroup analyses and sensitivity analyses were performed.ResultsTwenty-six studies (8,729 participants) with moderate to good quality were included. The pooled average age was 65.6 [95% confidence interval (CI) 63.7–67.6] years. The significant heterogeneity in SO definition and diagnosis among studies was observed. Patients with SO showed increased incidences of total complications (odds ratio 1.30, 95% CI: 1.03–1.64, P = 0.030) and major complications (Clavien-Dindo grade ≥ IIIa, odds ratio 2.15, 95% CI: 1.39–3.32, P = 0.001). SO was particularly associated with the incidence of cardiac complications, leak complications, and organ/space infection. SO was also predictive of poor overall survival (hazard ratio 1.73, 95% CI: 1.46–2.06, P < 0.001) and disease-free survival (hazard ratio 1.41, 95% CI: 1.20–1.66, P < 0.001). SO defined as sarcopenia in combination with obesity showed greater association with adverse outcomes than that defined as an increased ratio of fat mass to muscle mass. A low prevalence rate of SO (< 10%) was associated with increased significance for adverse outcomes compared to the high prevalence rate of SO (> 20%).ConclusionThe SO was associated with increased complications and poor survival in gastrointestinal surgical oncology. Interventions aiming at SO have potentials to promote surgery benefits for patients with gastrointestinal cancers. The heterogeneity in SO definition and diagnosis among studies should be considered when interpreting these findings.Systematic Review Registration[https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=255286], identifier [CRD42021255286].

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Relation between Sarcopenia and Surgical Site Infection in Patients Undergoing Gastric Cancer Surgery

Cited by 11 publications

References 16 publications

Effects of enhanced recovery after surgery nursing program on the surgical site wound infection and postoperative complications in patients of gastric cancer: A meta‐analysis

Effects of enhanced recovery after surgery nursing program on the surgical site wound infection and postoperative complications in patients of gastric cancer: A meta‐analysis

Detection of sarcopenic obesity and prediction of long‐term survival in patients with gastric cancer using preoperative computed tomography and machine learning

Sarcopenic obesity and therapeutic outcomes in gastrointestinal surgical oncology: A meta-analysis

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