Application of sarcopenia in predicting incisional hernia after colorectal cancer surgery

doi:10.3877/cma.j.issn.1674-392X.2024.06.009

Abstract

Abstract:

Objective

To investigate the impact and predictive value of sarcopenia on the occurrence of incisional hernia after colorectal cancer surgery.

Methods

A retrospective analysis was conducted on the clinical data of 150 patients who underwent radical surgery for colorectal cancer at Hangzhou First People's Hospital, Affiliated with the School of Medicine, Westlake University, from January 1, 2017, to December 31, 2019.Patients were divided into the incision hernia group (IH) and the non-incision hernia group (NIH) according to postoperative imaging findings.The preoperative muscle mass of patients was obtained by delineating the areas of different tissues at the level of the third lumbar vertebra (L3) in CT images.Cox regression was used to analyze the influence of sarcopenia and other clinical factors on postoperative incisional hernia in patients with colorectal cancer, and a nomogram model was established according to multivariate analysis to predict the risk of postoperative incisional hernia in patients with colorectal cancer.

Results

During the follow-up period, 26 patients (17.3%) developed incisional hernia after operation, and the skeletal muscle index (SMI) of L3 level in the IH group was(44.7±7.6) cm²/m², which was significantly lower than that in NIH group (49.1±9.0) cm²/m², the difference was statistically significant (t=-2.600, P=0.013).In multivariate analysis, it was found that sarcopenia(HR=3.709, P=0.004), rectal cancer (HR=3.982, P=0.002) and laparotomy (HR=2.404, P=0.043) were independent risk factors for the prognosis of postoperative incisional hernia in colorectal cancer, and a prediction model of postoperative incisional hernia in colorectal cancer was established accordingly.

Conclusion

Sarcopenia, rectal cancer and laparotomy are independent risk factors for postoperative incisional hernia in patients with colorectal cancer, which can be used to evaluate the incidence of postoperative incisional hernia.

Key words: Incisional hernia, Colorectal cancer, Sarcopenia, Prognosis

Zun Chen, Ping Wang, Hua Jin, Meiling Zhou, Qingqing Li, Yonggang Huang. Application of sarcopenia in predicting incisional hernia after colorectal cancer surgery[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2024, 18(06): 639-644.

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https://zhshfbwkzz.cma-cmc.com.cn/EN/Y2024/V18/I06/639

Figures/Tables 9

临床特征	切口疝(n=26)	非切口疝(n=124)	t/χ²值	P值
性别[例(%)]			5.572^a	0.018
男性	11(42.3)	83(66.9)
女性	15(57.7)	41(33.1)
年龄(岁, $\overset{ˉ}{x}$ ±s)	65.8±10.7	64.1±11.2	0.751	0.457
身高(cm, $\overset{ˉ}{x}$ ±s)	162.9±9.4	164.9±7.5	-1.019	0.316
体重(kg, $\overset{ˉ}{x}$ ±s)	60.2±11.4	62.9±10.8	-1.113	0.273
体重指数(kg/m², $\overset{ˉ}{x}$ ±s ))	22.6±3.3	23.1±3.2	-0.715	0.479
吸烟[例(%)]	5(19.2)	38(30.6)	1.369^a	0.242
糖尿病[例(%)]	1(3.8)	21(16.9)	2.942^a	0.158
腹腔镜手术[例(%)]	17(65.4)	104(83.8)	5.139^a	0.023
疾病类型[例(%)]			6.738^a	0.009
直肠癌	19(73.1)	58(46.8)
结肠癌	7(26.9)	70(56.5)
骨骼肌面积(cm², $\overset{ˉ}{x}$ ±s)	119.0±24.5	134.3±29.7	-2.801	0.008
骨骼肌指数(cm²/m², $\overset{ˉ}{x}$ ±s)	44.7±7.6	49.1±9.0	-2.600	0.013
皮下脂肪面积(cm², $\overset{ˉ}{x}$ ±s)	117.8±59.1	98.2±49.8	1.577	0.124
内脏脂肪面积(cm², $\overset{ˉ}{x}$ ±s)	103.3±62.5	116.6±69.7	-0.965	0.341

临床特征	切口疝(n=26)	非切口疝(n=124)	t/χ²值	P值
性别[例(%)]			5.572^a	0.018
男性	11(42.3)	83(66.9)
女性	15(57.7)	41(33.1)
年龄(岁, $\overset{ˉ}{x}$ ±s)	65.8±10.7	64.1±11.2	0.751	0.457
身高(cm, $\overset{ˉ}{x}$ ±s)	162.9±9.4	164.9±7.5	-1.019	0.316
体重(kg, $\overset{ˉ}{x}$ ±s)	60.2±11.4	62.9±10.8	-1.113	0.273
体重指数(kg/m², $\overset{ˉ}{x}$ ±s ))	22.6±3.3	23.1±3.2	-0.715	0.479
吸烟[例(%)]	5(19.2)	38(30.6)	1.369^a	0.242
糖尿病[例(%)]	1(3.8)	21(16.9)	2.942^a	0.158
腹腔镜手术[例(%)]	17(65.4)	104(83.8)	5.139^a	0.023
疾病类型[例(%)]			6.738^a	0.009
直肠癌	19(73.1)	58(46.8)
结肠癌	7(26.9)	70(56.5)
骨骼肌面积(cm², $\overset{ˉ}{x}$ ±s)	119.0±24.5	134.3±29.7	-2.801	0.008
骨骼肌指数(cm²/m², $\overset{ˉ}{x}$ ±s)	44.7±7.6	49.1±9.0	-2.600	0.013
皮下脂肪面积(cm², $\overset{ˉ}{x}$ ±s)	117.8±59.1	98.2±49.8	1.577	0.124
内脏脂肪面积(cm², $\overset{ˉ}{x}$ ±s)	103.3±62.5	116.6±69.7	-0.965	0.341

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