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INTRODUCTION: Sarcopaenia seems to be predictive factor for postoperative morbidity and mortality after colorectal resection for cancer. Nevertheless, an ideal sarcopaenic indicator is still to be identified. AIM: To evaluate computed tomography (CT) measured total abdominal muscle area (TAMA), total psoas muscle area (TPA), and psoas density (PD) - previously described sarcopaenia indicators - as possible risk factors for postoperative complications in patients after curative colon and rectal resections for colorectal cancer. MATERIAL AND METHODS: Consecutive patients after elective curative colon or rectal resection for cancer at a single institution were divided into cohorts with uncomplicated postoperative course or complications Clavien-Dindo grade I-II (Cl-Di 0-II) and complications Clavien-Dindo grade III-V (Cl-Di III-V). Cohorts were statistically tested for significant differences in TAMA, TPA, and PD calculated from preoperative staging CT scans at the level of the third lumbar vertebra. RESULTS: Data of 112 patients were analysed from a prospectively run database; 65 underwent colon and 47 rectal resections. PD was significantly higher in the Cl-Di 0-II cohort compared to the Cl-Di III-V for both colon (42.67 ±6.52 vs. 40.11 ±7.57 HU, p = 0.002) and rectal resections (44.08 ±5.86 vs. 43.03 ±5.70HU, p = 0.016). TAMA and TPA failed to show significant differences. CONCLUSIONS: Psoas density is significantly decreased in patients with Clavien-Dindo grade III-V complications after curative resection for colon and rectal cancer. Due to the simplicity and affordability of its assessment from preoperative staging CT scan, it might be considered an optimal sarcopaenic indicator to be utilised in everyday practice.
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INTRODUCTION: Bariatric procedures lead to changes in body composition. Desired fat loss may be accompanied by decrease of muscle mass, thus raising the risk of sarcopenia. AIM: To detect the risk of sarcopenia in patients 24 months after different bariatric/metabolic (B/M) procedures by DEXA. MATERIAL AND METHODS: Consecutive patients scheduled for a B/M procedure underwent DEXA scan and anthropometric assessment before and 24 months after surgery in a prospective manner. Obtained data were tested for significant differences (p < 0.05) to detect body composition changes and occurrence of sarcopenia. The International Physical Activity Questionnaire (IPAQ) was answered at 24 months to assess physical activity. RESULTS: Nineteen patients were enrolled, with no drop-off at follow-up. Body mass index dropped from 42.4 ±6.3 to 30.3 ±4.9 kg/m2, with excess weight loss of 72 ±25% and substantial improvement of all relevant anthropometric measurements (p < 0.001). Significant changes in DEXA parameters were observed: fat mass index (19.5 ±4.7 vs. 12.1 ±3.7 kg/m2), estimated visceral adipose area (235.8 ±70.0 vs. 126.5 ±50.4 cm2), lean mass index (22.1 ±2.4 vs. 18.1 ±2.3 kg/m2), appendage lean mass index (9.7 ±1.3 vs. 7.7 ±1.1 kg/m2), bone mineral content (1.22 ±0.1 vs. 1.12 ±0.1 kg), Z score (2.32 vs. 0.96) and T score (0.58 vs. -0.58). A low level of physical activity was recorded at 24 months. CONCLUSIONS: B/M procedures lead to significant changes in body composition at 24 months after surgery. DEXA detects these changes effectively. Desired fat loss is associated with significant reduction of skeletal muscle and bone mineral mass. As such, patients after B/M surgery are at risk of sarcopenia. A low level of physical activity may also play a negative role.