Asociación entre la densidad del músculo psoas y la fuga anastomótica en cirugía por cáncer colorrectal

Background: Previously published studies have shown the association between sarcopenia and short- and long-term postoperative outcomes in patients undergoing colorectal cancer surgery. Objective: To assess the association between radiologically defined sarcopenia measured by psoas density, anastomotic leakage and other postoperative outcomes in patients having a colorectal cancer resection. Methods: We conduct a case-control study identifying patients having resection and primary anastomosis for colorectal cancer. We evaluate the psoas muscle density at the level L3 vertebra from preoperative computed tomography scans. We collected sociodemographic variables and postoperative outcomes from medical records. Results: Data from 110 patients was analyzed, 36 met the case definition and 74 with the control definition. Sarcopenia, radiologically measured with the psoas muscle density and defined with a cutoff less than or equal to 49.5 Hounsfield Units, was associated with an increased risk of anastomosis leakage [OR 4.45 CI 95% (1.89 - 10.5) p < 0.001], postoperative ileus [OR 2.53 CI 95% (1.16 – 5.53) p. 0.02] and surgical site infection [OR 3.08 CI 95% (1.35 – 7.05) p. 0.01]. Conclusion: Sarcopenia, radiologically measured with L3-level psoas muscle density, may be a predictive factor for anastomotic leakage in patients having a colorectal cancer resection. It can be evaluated quickly and easily, prior to surgery, on the preoperative computed tomography scan.