Annals of Coloproctology

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Original Article

Malignant disease,Rectal cancer,Complication,Biomarker & risk factor

Cross-sectional area of psoas muscle as a predictive marker of anastomotic failure in male rectal cancer patients: Japanese single institutional retrospective observational study: Yusuke Mizuuchi, Yoshitaka Tanabe, Masafumi Sada, Koji Tamura, Kinuko Nagayoshi, Shuntaro Nagai, Yusuke Watanabe, Sadafumi Tamiya, Kohei Nakata, Kenoki Ohuchida, Toru Nakano, Masafumi Nakamura; Ann Coloproctol. 2022;38(5):353-361. Published online April 12, 2022; DOI: https://doi.org/10.3393/ac.2022.00122.0017

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Purpose
Preoperative sarcopenia worsens postoperative outcomes in various cancer types including colorectal cancer. However, we often experienced postoperative anastomotic leakage in muscular male patients such as Judo players, especially in rectal cancer surgery with lower anastomosis. It is controversial whether the whole skeletal muscle mass impacts the potential for anastomotic failure in male rectal cancer patients. Thus, the purpose of this study was to clarify whether skeletal muscle mass impacts anastomotic leakage in rectal cancer in men.
Methods
We reviewed the medical charts of male patients suffering from rectal cancer who underwent colo-procto anastomosis below the peritoneal reflection without a protective diverting stoma. We measured the psoas muscle area and calculated the psoas muscle index.
Results
One hundred ninety-seven male rectal cancer patients were enrolled in this study. The psoas muscle index was significantly higher in patients with anastomotic leakage (P<0.001). Receiver operating characteristic curve determined the optimal cut-off value of the psoas muscle index for predicting anastomotic leakage as 812.67 cm²/m² (sensitivity of 60% and specificity of 74.3%). Multivariate analysis revealed that high psoas muscle index (risk ratio [RR], 3.933; P<0.001; 95% confidence interval [CI], 1.917–8.070) and super low anastomosis (RR, 2.792; P=0.015; 95% CI, 1.221–6.384) were independent predictive factors of anastomotic leakage.
Conclusion
This study showed that male rectal cancer patients with a large psoas muscle mass who underwent lower anastomosis had a higher rate of postoperative anastomotic leakage.

Citations

Citations to this article as recorded by

Computed tomography derived body composition and risk of anastomotic leakage following rectal cancer surgery: A systematic review and meta-analysis
Mark Broekman, Charlotte M.S. Genders, Ritchie T.J. Geitenbeek, Klaas Havenga, Schelto Kruijff, Joost M. Klaase, Alain R. Viddeleer, Jeroen L.A. van Vugt, Esther C.J. Consten
Clinical Nutrition ESPEN.2026; 75: 103417. CrossRef
Complications After Rectal Cancer Surgery: Do Female Patients Fare Better? A Retrospective, Matched Cohort Analysis
Alexander I. Damanakis, Georg Dieplinger, Angela Ernst, Patricia K. Wyzlic, Alexander Quaas, Lars M. Schiffmann, Felix C. Popp, Hans F. Fuchs, Thomas Schmidt, Christiane J. Bruns
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Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
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Unraveling the role of computed tomography derived body composition metrics on anastomotic leakages rates in rectal cancer surgery: A protocol for a systematic review and meta-analysis
Mark Broekman, Charlotte M. S. Genders, Ritchie T. J. Geitenbeek, Klaas Havenga, Schelto Kruijff, Joost M. Klaase, Alain R. Viddeleer, Esther C. J. Consten, Ozlem Boybeyi-Turer
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Korean Journal of Radiology.2023; 24(9): 849. CrossRef
Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer
Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
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The Ewha Medical Journal.2023;[Epub] CrossRef
Can the cross-sectional area of the psoas muscle be a predictor of anastomotic failure in male rectal cancer patients?
Myong Hoon Ihn
Annals of Coloproctology.2022; 38(5): 333. CrossRef
Psoas Muscle Index – Could It Be an Indicator of Postoperative Complications in Colorectal Cancer? Case Presentation and Review of the Literature
Georgiana Alexandra Scurtu, Zsolt Zoltán Fülöp, Botond Kiss, Patricia Simu, Diana Burlacu, Tivadar Bara
Journal of Interdisciplinary Medicine.2022; 7(4): 100. CrossRef

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