Low skeletal muscle mass assessed directly from the 3rd cervical vertebra can predict pharyngocutaneous fistula risk after total laryngectomy in the male population
Casasayas, Maria (Institut d'Investigació Biomèdica Sant Pau)
García-Lorenzo, Jacinto (Hospital del Mar (Barcelona, Catalunya))
Gómez-Ansón, Beatriz (Institut d'Investigació Biomèdica Sant Pau)
Medina, Victoria (Institut d'Investigació Biomèdica Sant Pau)
Fernández-León, Alejandro (Institut d'Investigació Biomèdica Sant Pau)
Quer, Miquel (Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina)
León i Vintró, Xavier (Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina)
Universitat Autònoma de Barcelona

Fecha:	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.
Ayudas:	Instituto de Salud Carlos III FISPI19/01661
Nota:	Altres ajuts: acords transformatius de la UAB
Nota:	Altres ajuts: Open Access Funding provided by Universitat Autonoma de Barcelona. European Regional Development Fund (A Way to Build Europe).
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Head and neck squamous cell carcinoma ; Pharyngocutaneous fstula ; Total laryngectomy ; Sarcopenia ; Computed tomography
Publicado en:	European archives of oto-rhino-laryngology, 2021 , ISSN 1434-4726

DOI: 10.1007/s00405-021-07127-3
PMID: 34665301

11 p, 846.8 KB

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