The impact of sarcopenia on adverse events associated with gastric endoscopic submucosal dissection

Hisada, Hiroyuki; Tamura, Naoki; Tsuji, Yosuke; Nagao, Sayaka; Fukagawa, Kazushi; Miura, Yuko; Mizutani, Hiroya; Ohki, Daisuke; Yakabi, Seiichi; Minatsuki, Chihiro; Takahashi, Yu; Sakaguchi, Yoshiki; Yamamichi, Nobutake; Fujishiro, Mitsuhiro

doi:10.1007/s00464-021-08965-2

Cited by 12 publications

(13 citation statements)

References 30 publications

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“…Additionally, it is worth noting that there are three studies by Hiroyuki Hisada et al included in the meta-analysis. One of these studies focused on patients with colorectal tumors [27], while the other two focused on early gastric cancer patients [28,29]. Furthermore, the two studies were conducted with overlapping time periods.…”

Section: Resultsmentioning

confidence: 99%

Clinical significance of sarcopenia in elderly patients undergoing endoscopic submucosal dissection - A systematic review and meta-analysis

Su,

Wu,

et al. 2024

Preprint

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Background and Aims: As global life expectancy rises and gastrointestinal tumor incidence increases, more elderly patients are undergoing endoscopic submucosal dissection (ESD) for tumor treatment. This highlights the importance of sarcopenia assessment before ESD. This systematic review and meta-analysis aims to assess sarcopenia's role in predicting post-ESD adverse outcomes in the elderly. Methods: We conducted a systematic review and meta-analysis to investigate the impact of sarcopenia on the prognosis of elderly patients undergoing ESD treatment. A comprehensive search was conducted across three databases (PubMed, Embase, Web of Science). Using NEWCASTLE - OTTAWA ASSESSMENT SCALE for risk of bias assessment. The data were synthesized using Review Manager 5.3. Results: A total of 9 reports were identified, analyzing 7 indicators, with a combined sample size of 6044. Through a series of analyses, we have derived several highly credible research findings: the overall OR and 95% CI for gastric and colorectal post-ESD perforation between sarcopenia and nonsarcopenia groups were 1.34 [0.92, 1.97], for CTCAE grade > 2 were 2.65 [1.45, 4.82], for gastric post-ESD pneumonia were 1.90 [1.24, 2.90], and for gastric post-ESD mortality within 5 years were 2.96 [1.33, 6.58]. Conclusions: Sarcopenia is a risk factor for increased incidence of complications (CTCAE > 2) after undergoing gastric and colorectal ESD, increased pneumonia rates and higher mortality rates within five years following gastric ESD treatment in elderly patients. However, sarcopenia does not lead to an increased perforation rate in elderly patients undergoing gastric and colorectal ESD treatments.

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Section: Resultsmentioning

confidence: 99%

Clinical significance of sarcopenia in elderly patients undergoing endoscopic submucosal dissection - A systematic review and meta-analysis

Su,

Wu,

et al. 2024

Preprint

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“…A connection between the GNRI and postoperative complications in GC patients was observed in a total of 6 studies that involved 3565 individuals. Hisada et al assessed ESD-related complications based on the Common Terminology Criteria for Adverse Events version 5.0, with a CTCAE grade of ≥2 being considered as an adverse event [ 28 ]. In the remaining five studies, according to the Clavien Dindo classification, postoperative complications were categorized as a grade ≥ II [ 29 ].…”

Section: Resultsmentioning

confidence: 99%

The Prognostic Value of the GNRI in Patients with Stomach Cancer Undergoing Surgery

Zhang

Jin

et al. 2023

JPM

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Malnutrition often induces an adverse prognosis in cancer surgery patients. The elderly nutrition risk index (GNRI) is an example of the objective indicators of nutrition-related risks. We performed a meta-analysis to thoroughly examine the evidence for the GNRI in predicting the outcomes of patients undergoing stomach cancer surgery. Eligible articles were retrieved using PubMed, the Cochrane Library, EMBASE, and Google Scholar by 24 October 2022. The clinical outcomes were overall survival (OS), cancer-specific survival (CSS), and post-operative complications. A total of 11 articles with 5593 patients were included in this meta-analysis. The combined forest plot showed that for every unit increase in the preoperative GNRI score in patients with stomach cancer, their postoperative mortality was reduced by 5.6% (HR: 0.944; 95% CI: 0.933–0.956, p < 0.001). The pooled results also demonstrated that a low GNRI was correlated with poor OS (HR: 2.052; 95% CI: 1.726–2.440, p < 0.001) and CSS (HR: 1.684; 95% CI: 1.249–2.270, p = 0.001) in patients who underwent stomach cancer surgery. Postoperative complications were more likely to occur in patients with a low GNRI, as opposed to those with a high GNRI (OR: 1.768; 95% CI: 1.445–2.163, p < 0.001). There was no evidence of significant heterogeneity, and the sensitivity analysis supported the stability and dependability of the above results. the GNRI is a valuable predictor of long-term outcomes and complications in stomach cancer patients undergoing surgery.

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“…Previous reports have discussed the prognostic and risk factors for complications of ESD and other surgical procedures [ 59 , 60 , 61 ]. Age [ 62 , 63 ], body mass index (BMI) [ 64 , 65 ], surgical duration [ 66 ], resection area [ 32 ], and nutritional status [ 67 , 68 ] are commonly reported factors. Kudo et al reported that among factors such as age, BMI, total resection area, surgical duration, and sarcopenia, only the total resection area was associated with changes in the REE during the perioperative period of ESD for early-stage esophageal cancer [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Assessment of the Physical Invasiveness of Peroral Endoscopic Myotomy during the Perioperative Period Based on Changes in Energy Metabolism

Chinda,

Shimoyama,

Fujiwara

et al. 2023

Metabolites

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A novel treatment method for achalasia of the esophagus and related disorders is known as peroral endoscopic myotomy (POEM). This study aimed to calculate the resting energy expenditure (REE) and evaluated the degree of physical invasiveness based on metabolic changes during the perioperative period of POEM. Fifty-eight patients who underwent POEM were prospectively enrolled; REE, body weight (BW), and basal energy expenditure were measured on the day of POEM, postoperative day 1 (POD 1), and three days after POEM (POD 3). The median REE/BW increased from 19.6 kcal/kg on the day of POEM to 24.5 kcal/kg on POD 1. On POD 3, it remained elevated at 20.9 kcal/kg. The stress factor on POD 1 was 1.20. Among the factors, including the Eckardt score, operation time, and the length of myotomy, the length of myotomy was associated with changes in REE/BW. During the perioperative period of POEM, the level of variation in energy expenditure was lower than that of esophageal cancer surgeries performed under general anesthesia. However, because the length of myotomy is a factor affecting changes in energy expenditure, careful perioperative management is desirable for patients with longer myotomy lengths.

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The impact of sarcopenia on adverse events associated with gastric endoscopic submucosal dissection

Cited by 12 publications

References 30 publications

Clinical significance of sarcopenia in elderly patients undergoing endoscopic submucosal dissection - A systematic review and meta-analysis

Clinical significance of sarcopenia in elderly patients undergoing endoscopic submucosal dissection - A systematic review and meta-analysis

The Prognostic Value of the GNRI in Patients with Stomach Cancer Undergoing Surgery

Assessment of the Physical Invasiveness of Peroral Endoscopic Myotomy during the Perioperative Period Based on Changes in Energy Metabolism

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