Sarcopenia, but not visceral fat amount, is a risk factor of postoperative complications after major hepatectomy.
BACKGROUND
Major hepatectomy is associated with significant morbidity and mortality rates, particularly in patients aged more than 70 years. This study assessed whether physical indicators, such as sarcopenia and visceral fat amount, could predict morbidity and mortality after major hepatectomy.


METHODS
The study enrolled 144 patients who underwent curative major hepatectomy. Skeletal muscle and visceral fat amount at the third lumbar vertebra (L3) in the inferior direction were quantified using enhanced computed tomography scans. The patients were divided into two subgroups, with and without sarcopenia, based on median skeletal muscle mass in men and women (43.2 cm(2)/m(2) in men; 35.3 cm(2)/m(2) in women).


RESULTS
The study included 108 men and 36 women, with median skeletal muscle tissue of 43.2 and 35.3 cm(2)/m(2), respectively. The mortality rate was significantly higher in patients with than without sarcopenia [seven cases (9.7 %), one case (1.4 %), respectively; P = 0.021], whereas liver-related morbidity and mortality rates were similar. In patients aged >70 years, the morbidity, liver dysfunction-related morbidity, and mortality rates were significantly higher in patients with than without sarcopenia (P < 0.05 each). In contrast, surgical outcomes were similar in patients with high and low visceral fat amounts.


CONCLUSIONS
Sarcopenia was a risk factor for postoperative complications after major hepatectomy, particularly in elderly patients.
Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
Takaaki
T
Higashi
Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
Hiromitsu
H
Hayashi
Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
Katsunobu
K
Taki
Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
Keita
K
Sakamoto
Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
Hideyuki
H
Kuroki
Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
Hidetoshi
H
Nitta
Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
Daisuke
D
Hashimoto
Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
Akira
A
Chikamoto
Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
Toru
T
Beppu
Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan. hdobaba@kumamoto-u.ac.jp.
Hideo
H
Baba
D000368:Aged; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging*; D008161:Lumbosacral Region / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging*; D012307:Risk Factors; D055948:Sarcopenia / Q000150:complications* / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
Complications; Major hepatectomy; Sarcopenia