Low skeletal muscle mass assessed directly from the 3rd cervical vertebra can predict pharyngocutaneous fistula risk after total laryngectomy in the male population


Por: Casasayas, M, Garcia-Lorenzo, J, Gomez-Anson, B, Medina, V, Fernandez, A, Quer, M, Leon, X

Publicada: 1 feb 2022 Ahead of Print: 1 oct 2021
Resumen:
Purpose Skeletal muscle mass (SMM) loss and sarcopenia have been identified as risk factors for postoperative complications. The aim of this study was to investigate the relationship between pharyngocutaneous fistula (PCF) formation after total laryngectomy (TL) and SMM assessed from a computed tomography image of the 3rd cervical vertebra (C3). Methods Retrospective study of 86 male patients who underwent TL between 2013 and 2019 in a single institution. We excluded women from the analysis due to our limited sample. SMM was determined from cross-sectional muscle area (CSMA) measurement at C3 using the ImageJ software. Results were compared with those for the skeletal muscle mass index (SMMI) calculated from the estimated measure at 3rd lumbar vertebra (L3). Results PCF formation occurred in 21/86 patients. According to the CSMA at a C3 cut-off of 35.5cm2, of 18 patients (20.9%) with low SMM, 9 developed PCFs (50.0%). Among patients with normal SMM (n = 68, 79.1%), 12 developed PCFs (17.6%). The CSMA at C3 was the only variable significantly associated with PCF risk, which was 4.7 times greater in patients with low SMM (p = 0.007). Sarcopenia was more frequent in underweight patients (p = 0.0001), patients undergoing extended surgeries (p = 0.003), or presenting preoperative anaemia (p = 0.009) or hypoalbuminemia (p = 0.027). Conclusion Measuring the CSMA at C3 obtained results equivalent to those obtained by calculating the SMMI at L3, suggesting that direct SMM assessment from C3 is a useful approach to evaluating PCF formation risk after TL.

Filiaciones:
Casasayas, M:
 Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Serv Otorrinolaringol, C Mas Casanovas 90, Barcelona 08041, Spain

Garcia-Lorenzo, J:
 Hosp del Mar, Serv Otorrinolaringol, Barcelona, Spain

Gomez-Anson, B:
 Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Unidad Neuroradiol, Serv Radiodiagnost, Barcelona, Spain

Medina, V:
 Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Unidad Neuroradiol, Serv Radiodiagnost, Barcelona, Spain

Fernandez, A:
 Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Serv Med Nucl, Barcelona, Spain

Quer, M:
 Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Serv Otorrinolaringol, C Mas Casanovas 90, Barcelona 08041, Spain

 Ctr Invest Biomed Red Bioingn Biomat & Nanomed CI, Madrid, Spain

Leon, X:
 Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Serv Otorrinolaringol, C Mas Casanovas 90, Barcelona 08041, Spain

 Ctr Invest Biomed Red Bioingn Biomat & Nanomed CI, Madrid, Spain
ISSN: 09374477
Editorial
SPRINGER, ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES, Alemania
Tipo de documento: Article
Volumen: 279 Número: 2
Páginas: 853-863
WOS Id: 000708777300001
ID de PubMed: 34665301
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