Sarcopenia is associated with increased severe postoperative complications after colon cancer surgery.

INTRODUCTION: Studies have shown that sarcopenia is associated with poor outcomes in patients with gastrointestinal cancer undergoing surgery. We aimed to investigate the relationship between postoperative complications of sarcopenic patients who had been operated on for colon cancer and the effects on short-term mortality. MATERIAL AND METHODS: In this study, patients who had undergone colon cancer surgery between January 2013 and December 2018 were collected retrospectively. Sarcopenia was diagnosed by the skeletal muscle index (SMI) derived from a preoperative computed tomography scan. Multiple logistic regression analysis was performed to determine whether sarcopenia is associated with postoperative major complications (POMC). RESULTS: The study included 160 patients with a mean age of 62.4 ±12.6 years. Clavien-Dindo grade 1-2 (minor) complications were not significantly different between the groups (p = 0.896). However, grade ≥ 3 (major) complications were detected in 13 (17.8%) patients in the sarcopenic group (SG) and in 5 patients in the non-sarcopenic group (NSG) (5.7%) (p = 0.016). Length of intensive care unit (ICU) stay was longer in SG (p = 0.002) and there was no difference between 1-month and 6-month mortality rates (p = 0.273 and p = 0.402, respectively). According to univariate analyses, sarcopenia and age over 65 years were related to POMC. In multivariate analyses, sarcopenia (odds ratio = 3.039; 95% confidence interval 1.008-9.174; p = 0.048) and advanced age (odds ratio = 3.246; 95% confidence interval 1.078-9.803; p = 0.036) were found to be independent risk factors for POMC. CONCLUSIONS: This study showed that while sarcopenia is a risk factor for POMC, sarcopenia also prolongs the duration of ICU stay. Also sarcopenia has no effect on short-term mortality.

The safety of upper gastrointestinal endoscopic biopsy in patients receiving antithrombic drugs. A single-centre prospective observational study.

INTRODUCTION: In July 2012, the Japan Gastroenterological Endoscopy Society updated their guidelines on gastroenterological endoscopy in patients undergoing antithrombotic therapy, although the safety of endoscopic procedures in patients receiving antithrombotic drugs has yet to be sufficiently studied. AIM: This study evaluates the safety of upper gastroenterological endoscopic biopsy in patients receiving antithrombotic drugs. We evaluated the prospective observational safety of endoscopic biopsy performed in the endoscopy unit of our patients using antithrombotic drugs. MATERIAL AND METHODS: Oesophagogastroduodenoscopies (OGD) and biopsies performed at a single endoscopy unit between July 2018 and February 2019 were examined in this prospective observational study. Patients receiving antithrombotic drugs due to cardiovascular and neurological reasons, who underwent an endoscopic mucosal biopsy for diagnostic purposes, were included in the study. RESULTS: The study was completed with 166 patients who underwent an endoscopic biopsy, from whom a total of 327 biopsies taken. The patients were examined in two groups: those "receiving antithrombotic drugs" and those who had "stopped taking antithrombotic drugs". There was no statistically significant difference between the two groups with respect to bleeding. CONCLUSIONS: This prospective observational study showed that performing an endoscopic biopsy without the cessation of antithrombotic drugs does not increase bleeding risk. Low-risk procedures, such as endoscopic mucosal biopsies, can be performed confidently by experienced endoscopists.