Intramuscular Adipose Tissue Content as a Predictor of Incisional Hernia after Hepatic Resection.
Journal
World journal of surgery
ISSN: 1432-2323
Titre abrégé: World J Surg
Pays: United States
ID NLM: 7704052
Informations de publication
Date de publication:
01 2023
01 2023
Historique:
accepted:
08
10
2022
pubmed:
20
10
2022
medline:
15
12
2022
entrez:
19
10
2022
Statut:
ppublish
Résumé
Incisional hernia (IH) is a common surgical complication, with an incidence of 6-31% following major abdominal surgery. This study aimed to investigate the impact of intramuscular adipose tissue content (IMAC) on the incidence of IH in patients who underwent hepatic resection. Data of 205 patients who underwent open hepatic resection between 2007 and 2019 at Ehime University Hospital were retrospectively analyzed. Patient characteristics, perioperative findings, and body composition were compared between patients with IH and those without IH. The quantity and quality of skeletal muscle, calculated as skeletal muscle index and IMAC, were evaluated using preoperative computerized tomography images. Forty (19.5%) patients were diagnosed with IH. The cumulative incidence rates were 15.6% at 1 year and 19.6% at 3 years. On univariate analysis, body mass index, areas of subcutaneous and visceral fat, and IMAC were significantly higher in the IH group than in the non-IH group (p = 0.0023, 0.0070, 0.0047, and 0.0080, respectively). No significant difference in skeletal muscle index was found between the groups (p = 0.3548). The incidence of diabetes mellitus, intraoperative transfusion, and postoperative wound infection was significantly higher in the IH group than in the non-IH group (p = 0.0361, 0.0078, and 0.0299, respectively). On multivariate analysis, a high IMAC and wound infection were independent risk factors for IH (adjusted odds ratio, 2.83 and 4.52, respectively; p = 0.0152 and 0.0164, respectively). IMAC can predict the incidence of IH in patients undergoing hepatic resection.
Sections du résumé
BACKGROUND
Incisional hernia (IH) is a common surgical complication, with an incidence of 6-31% following major abdominal surgery. This study aimed to investigate the impact of intramuscular adipose tissue content (IMAC) on the incidence of IH in patients who underwent hepatic resection.
METHODS
Data of 205 patients who underwent open hepatic resection between 2007 and 2019 at Ehime University Hospital were retrospectively analyzed. Patient characteristics, perioperative findings, and body composition were compared between patients with IH and those without IH. The quantity and quality of skeletal muscle, calculated as skeletal muscle index and IMAC, were evaluated using preoperative computerized tomography images.
RESULTS
Forty (19.5%) patients were diagnosed with IH. The cumulative incidence rates were 15.6% at 1 year and 19.6% at 3 years. On univariate analysis, body mass index, areas of subcutaneous and visceral fat, and IMAC were significantly higher in the IH group than in the non-IH group (p = 0.0023, 0.0070, 0.0047, and 0.0080, respectively). No significant difference in skeletal muscle index was found between the groups (p = 0.3548). The incidence of diabetes mellitus, intraoperative transfusion, and postoperative wound infection was significantly higher in the IH group than in the non-IH group (p = 0.0361, 0.0078, and 0.0299, respectively). On multivariate analysis, a high IMAC and wound infection were independent risk factors for IH (adjusted odds ratio, 2.83 and 4.52, respectively; p = 0.0152 and 0.0164, respectively).
CONCLUSION
IMAC can predict the incidence of IH in patients undergoing hepatic resection.
Identifiants
pubmed: 36261603
doi: 10.1007/s00268-022-06795-4
pii: 10.1007/s00268-022-06795-4
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
260-268Informations de copyright
© 2022. The Author(s) under exclusive licence to Société Internationale de Chirurgie.
Références
Kayashima H, Maeda T, Harada N et al (2015) Risk factors for incisional hernia after hepatic resection for hepatocellular carcinoma in patients with liver cirrhosis. Surgery 158:1669–1675. https://doi.org/10.1016/j.surg.2015.06.001
doi: 10.1016/j.surg.2015.06.001
Chen-Xu J, Bessa-Melo R, Graça L, Costa-Maia J (2019) Incisional hernia in hepatobiliary and pancreatic surgery: Incidence and risk factors. Hernia 23:67–79. https://doi.org/10.1007/s10029-018-1847-4
doi: 10.1007/s10029-018-1847-4
Togo S, Nagano Y, Masumoto C et al (2008) Outcome of and risk factors for incisional hernia after partial hepatectomy. J Gastrointest Surg 12:1115–1120. https://doi.org/10.1007/s11605-008-0469-z
doi: 10.1007/s11605-008-0469-z
National Audit of Small Bowel Obstruction Steering Group and National Audit of Small Bowel Obstruction Collaborators, NASBO Steering Group, NASBO Collaborators, et al (2020) Outcomes of obstructed abdominal wall hernia: Results from the UK national small bowel obstruction audit. BJS Open 4:924–934. doi: https://doi.org/10.1002/bjs5.50315
Howie A, Sandblom G, Enochsson L, Österberg J (2020) Incisional hernias following gallstone surgery. A Popul-Based Study HPB (Oxford) 22:1775–1781. https://doi.org/10.1016/j.hpb.2020.04.003
doi: 10.1016/j.hpb.2020.04.003
Aquina CT, Rickles AS, Probst CP et al (2015) Visceral obesity, not elevated BMI, is strongly associated with incisional hernia after colorectal surgery. Dis Colon Rectum 58:220–227. https://doi.org/10.1097/DCR.0000000000000261
doi: 10.1097/DCR.0000000000000261
Yamada T, Okabayashi K, Hasegawa H et al (2016) Age, preoperative subcutaneous fat area, and open laparotomy are risk factors for incisional hernia following colorectal cancer surgery. Ann Surg Oncol 23(Supplement 2):S236–S241. https://doi.org/10.1245/s10434-015-4462-y
doi: 10.1245/s10434-015-4462-y
Valencia S, Shindo K, Moriyama T et al (2020) Subcutaneous fat area as a risk factor for extraction site incisional hernia following gastrectomy for gastric cancer. Surg Today 50:1418–1426. https://doi.org/10.1007/s00595-020-02039-x
doi: 10.1007/s00595-020-02039-x
Frontera WR, Ochala J (2015) Skeletal muscle: a brief review of structure and function. Calcif Tissue Int 96:183–195. https://doi.org/10.1007/s00223-014-9915-y
doi: 10.1007/s00223-014-9915-y
Miljkovic I, Zmuda JM (2010) Epidemiology of myosteatosis. Curr Opin Clin Nutr Metab Care 13:260–264. https://doi.org/10.1097/MCO.0b013e328337d826
doi: 10.1097/MCO.0b013e328337d826
Zhuang CL, Shen X, Huang YY et al (2019) Myosteatosis predicts prognosis after radical gastrectomy for gastric cancer: a propensity score-matched analysis from a large-scale cohort. Surgery 166:297–304. https://doi.org/10.1016/j.surg.2019.03.020
doi: 10.1016/j.surg.2019.03.020
Sueda T, Takahasi H, Nishimura J et al (2018) Impact of low muscularity and myosteatosis on long-term outcome after curative colorectal cancer surgery: a propensity score-matched analysis. Dis Colon Rectum 61:364–374. https://doi.org/10.1097/DCR.000000000000095812
doi: 10.1097/DCR.000000000000095812
Srpcic M, Jordan T, Popuri K, Sok M (2020) Sarcopenia and myosteatosis at presentation adversely affect survival after esophagectomy for esophageal cancer. Radiol Oncol 54:237–246. https://doi.org/10.2478/raon-2020-001613
doi: 10.2478/raon-2020-001613
Kitajima Y, Hyogo H, Sumida Y et al (2013) Severity of non-alcoholic steatohepatitis is associated with substitution of adipose tissue in skeletal muscle. J Gastroenterol Hepatol 28:1507–1514. https://doi.org/10.1111/jgh.12227
doi: 10.1111/jgh.12227
Hamaguchi Y, Kaido T, Okumura S et al (2015) Preoperative intramuscular adipose tissue content is a novel prognostic predictor after hepatectomy for hepatocellular carcinoma. J Hepatobiliary Pancreat Sci 22:475–485. https://doi.org/10.1002/jhbp.236
doi: 10.1002/jhbp.236
Hamaguchi Y, Kaido T, Okumura S et al (2014) Impact of quality as well as quantity of skeletal muscle on outcomes after liver transplantation. Liver Transpl 20:1413–1419. https://doi.org/10.1002/lt.23970
doi: 10.1002/lt.23970
Bailey CM, Schaverien MV, Garvey PB et al (2020) The impact of sarcopenia on oncologic abdominal wall reconstruction. J Surg Oncol 122:1490–1497. https://doi.org/10.1002/jso.26171
doi: 10.1002/jso.26171
Mitsiopoulos N, Baumgartner RN, Heymsfield SB et al (1985) (1998) Cadaver validation of skeletal muscle measurement by magnetic resonance imaging and computerized tomography. J Appl Physiol 85:115–122. https://doi.org/10.1152/jappl.1998.85.1.115
doi: 10.1152/jappl.1998.85.1.115
Cruz-Jentoft AJ, Baeyens JP, Bauer JM et al (2010) Sarcopenia: European consensus on definition and diagnosis: report of the European working group on sarcopenia in older people. Age Ageing 39:412–423. https://doi.org/10.1093/ageing/afq034
doi: 10.1093/ageing/afq034
Hamaguchi Y, Kaido T, Okumura S et al (2017) Impact of skeletal muscle mass index, intramuscular adipose tissue content, and visceral to subcutaneous adipose tissue area ratio on early mortality of living donor liver transplantation. Transplantation 101:565–574. https://doi.org/10.1097/TP.0000000000001587
doi: 10.1097/TP.0000000000001587
Strasberg SM, Phillips C (2013) Use and dissemination of the Brisbane 2000 nomenclature of liver anatomy and resections. Ann Surg 257:377–382. https://doi.org/10.1097/SLA.0b013e31825a01f6
doi: 10.1097/SLA.0b013e31825a01f6
Mangram AJ, Horan TC, Pearson ML et al (1999) Guideline for prevention of surgical site infection, 1999. Am J Infect Control 27(2):97–134. https://doi.org/10.1016/S0196-6553(99)70088-X
doi: 10.1016/S0196-6553(99)70088-X
Okugawa Y, Toiyama Y, Yamamoto A et al (2018) Clinical impact of muscle quantity and quality in colorectal cancer patients: a propensity score matching analysis. JPEN J Parenter Enter Nutr 42:1322–1333. https://doi.org/10.1002/jpen.1171
doi: 10.1002/jpen.1171
Kitajima Y, Eguchi Y, Ishibashi E et al (2010) Age-related fat deposition in multifidus muscle could be a marker for nonalcoholic fatty liver disease. J Gastroenterol 45:218–224. https://doi.org/10.1007/s00535-009-0147-2
doi: 10.1007/s00535-009-0147-2
Hamaguchi Y, Kaido T, Okumura S et al (2016) Muscle steatosis is an independent predictor of postoperative complications in patients with hepatocellular carcinoma. World J Surg 40:1959–1968. https://doi.org/10.1007/s00268-016-3504-3
doi: 10.1007/s00268-016-3504-3
van Rooijen MMJ, Kroese LF, van Vugt JLA, Lange JF (2019) Sarcomania? The inapplicability of sarcopenia measurement in predicting incisional hernia development. World J Surg 43:772–779. https://doi.org/10.1007/s00268-018-4837-x
doi: 10.1007/s00268-018-4837-x
Walming S, Angenete E, Block M et al (2017) Retrospective review of risk factors for surgical wound dehiscence and incisional hernia. BMC Surg 17:19. https://doi.org/10.1186/s12893-017-0207-0
doi: 10.1186/s12893-017-0207-0
Robson MC, Hill DP, Woodske ME, Steed DL (2000) Wound healing trajectories as predictors of effectiveness of therapeutic agents. Arch Surg 135:773–777. https://doi.org/10.1001/archsurg.135.7.773
doi: 10.1001/archsurg.135.7.773
Shirata C, Hasegawa K, Kokudo T et al (2018) Surgical site infection after hepatectomy for hepatocellular carcinoma. Dig Surg 35:204–211. https://doi.org/10.1159/000477777
doi: 10.1159/000477777
Franz MG (2008) The biology of hernia formation. Surg Clin North Am 88(1):1–15. https://doi.org/10.1016/j.suc.2007.10.007
doi: 10.1016/j.suc.2007.10.007
Miljkovic I, Kuipers AL, Kammerer CM et al (2011) Markers of inflammation are heritable and associated with subcutaneous and ectopic skeletal muscle adiposity in African ancestry families. Metab Syndr Relat Disord 9:319–326. https://doi.org/10.1089/met.2010.0133
doi: 10.1089/met.2010.0133
Robson MC, Shaw RC, Heggers JP (1970) The reclosure of postoperative incisional abscesses based on bacterial quantification of the wound. Ann Surg 171:279–282. https://doi.org/10.1097/00000658-197002000-00017
doi: 10.1097/00000658-197002000-00017
Tamura Y, Tanaka Y, Sato F et al (2005) Effects of diet and exercise on muscle and liver intracellular lipid contents and insulin sensitivity in type 2 diabetic patients. J Clin Endocrinol Metab 90:3191–3196. https://doi.org/10.1210/jc.2004-1959
doi: 10.1210/jc.2004-1959