Impact of preoperative nutritional support and rehabilitation therapy in patients undergoing pancreaticoduodenectomy

Mariko Tsukagoshi; Norifumi Harimoto; Kenichiro Araki; Norio Kubo; Akira Watanabe; Takamichi Igarashi; Norihiro Ishii; Takahiro Yamanaka; Kei Hagiwara; Kouki Hoshino; Ryo Muranushi; Toshiki Yajima; Naoki Wada; Ken Shirabe

doi:10.1007/s10147-021-01958-0

Impact of preoperative nutritional support and rehabilitation therapy in patients undergoing pancreaticoduodenectomy

Mariko Tsukagoshi, Norifumi Harimoto^*, Kenichiro Araki, Norio Kubo, Akira Watanabe, Takamichi Igarashi, Norihiro Ishii, Takahiro Yamanaka, Kei Hagiwara, Kouki Hoshino, Ryo Muranushi, Toshiki Yajima, Naoki Wada, Ken Shirabe

^*Corresponding author for this work

Department of Surgery & Science

Research output: Contribution to journal › Article › peer-review

26 Scopus citations

Abstract

Background: Sarcopenia is closely associated with morbidity after pancreatic surgery. We investigated the impact of preoperative nutritional support and rehabilitation on patients undergoing pancreaticoduodenectomy. Methods: This was a retrospective analysis of 101 patients who underwent pancreaticoduodenectomy. Skeletal muscle (SM) loss was defined using the SM index (cutoff level: 42 cm²/m² in men and 38 cm²/m² in women). A total of 33 and 30 patients received preoperative nutrition and prehabilitation, respectively. The neutrophil-to-lymphocyte ratio (NLR), Prognostic Nutritional Index (PNI), and modified Glasgow Prognostic Score (mGPS) values were calculated during the first visit and immediately before surgery. Results: SM loss was present in 65 of 101 patients and was significantly correlated with female sex, older age, lower body mass index, and low PNI. Preoperative nutritional support and prehabilitation prevented the decrease in PNI values in patients with SM loss. The NLR significantly improved in patients with SM loss who received nutritional support and prehabilitation. In patients with SM loss, the lack of preoperative nutrition and prehabilitation was an independent risk factor for postoperative pancreatic fistula. Conclusions: Preoperative nutritional support and prehabilitation may reduce the incidence of pancreatic fistula in patients with SM loss and improve the surgical outcomes of patients undergoing pancreaticoduodenectomy.

Original language	English
Pages (from-to)	1698-1706
Number of pages	9
Journal	International Journal of Clinical Oncology
Volume	26
Issue number	9
DOIs	https://doi.org/10.1007/s10147-021-01958-0
State	Published - 2021/09

Keywords

Nutrition
Pancreatic fistula
Pancreaticoduodenectomy
Rehabilitation
Sarcopenia
Skeletal muscle loss

ASJC Scopus subject areas

Surgery
Hematology
Oncology

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Tsukagoshi, M., Harimoto, N., Araki, K., Kubo, N., Watanabe, A., Igarashi, T., Ishii, N., Yamanaka, T., Hagiwara, K., Hoshino, K., Muranushi, R., Yajima, T., Wada, N., & Shirabe, K. (2021). Impact of preoperative nutritional support and rehabilitation therapy in patients undergoing pancreaticoduodenectomy. International Journal of Clinical Oncology, 26(9), 1698-1706. https://doi.org/10.1007/s10147-021-01958-0

@article{70c5e2950c2a41e5b581c41bada1ecaf,

title = "Impact of preoperative nutritional support and rehabilitation therapy in patients undergoing pancreaticoduodenectomy",

abstract = "Background: Sarcopenia is closely associated with morbidity after pancreatic surgery. We investigated the impact of preoperative nutritional support and rehabilitation on patients undergoing pancreaticoduodenectomy. Methods: This was a retrospective analysis of 101 patients who underwent pancreaticoduodenectomy. Skeletal muscle (SM) loss was defined using the SM index (cutoff level: 42 cm2/m2 in men and 38 cm2/m2 in women). A total of 33 and 30 patients received preoperative nutrition and prehabilitation, respectively. The neutrophil-to-lymphocyte ratio (NLR), Prognostic Nutritional Index (PNI), and modified Glasgow Prognostic Score (mGPS) values were calculated during the first visit and immediately before surgery. Results: SM loss was present in 65 of 101 patients and was significantly correlated with female sex, older age, lower body mass index, and low PNI. Preoperative nutritional support and prehabilitation prevented the decrease in PNI values in patients with SM loss. The NLR significantly improved in patients with SM loss who received nutritional support and prehabilitation. In patients with SM loss, the lack of preoperative nutrition and prehabilitation was an independent risk factor for postoperative pancreatic fistula. Conclusions: Preoperative nutritional support and prehabilitation may reduce the incidence of pancreatic fistula in patients with SM loss and improve the surgical outcomes of patients undergoing pancreaticoduodenectomy.",

keywords = "Nutrition, Pancreatic fistula, Pancreaticoduodenectomy, Rehabilitation, Sarcopenia, Skeletal muscle loss",

author = "Mariko Tsukagoshi and Norifumi Harimoto and Kenichiro Araki and Norio Kubo and Akira Watanabe and Takamichi Igarashi and Norihiro Ishii and Takahiro Yamanaka and Kei Hagiwara and Kouki Hoshino and Ryo Muranushi and Toshiki Yajima and Naoki Wada and Ken Shirabe",

note = "Publisher Copyright: {\textcopyright} 2021, Japan Society of Clinical Oncology.",

year = "2021",

month = sep,

doi = "10.1007/s10147-021-01958-0",

language = "英語",

volume = "26",

pages = "1698--1706",

journal = "International Journal of Clinical Oncology",

issn = "1341-9625",

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number = "9",

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Tsukagoshi, M, Harimoto, N, Araki, K, Kubo, N, Watanabe, A, Igarashi, T, Ishii, N, Yamanaka, T, Hagiwara, K, Hoshino, K, Muranushi, R, Yajima, T, Wada, N & Shirabe, K 2021, 'Impact of preoperative nutritional support and rehabilitation therapy in patients undergoing pancreaticoduodenectomy', International Journal of Clinical Oncology, vol. 26, no. 9, pp. 1698-1706. https://doi.org/10.1007/s10147-021-01958-0

TY - JOUR

T1 - Impact of preoperative nutritional support and rehabilitation therapy in patients undergoing pancreaticoduodenectomy

AU - Tsukagoshi, Mariko

AU - Harimoto, Norifumi

AU - Araki, Kenichiro

AU - Kubo, Norio

AU - Watanabe, Akira

AU - Igarashi, Takamichi

AU - Ishii, Norihiro

AU - Yamanaka, Takahiro

AU - Hagiwara, Kei

AU - Hoshino, Kouki

AU - Muranushi, Ryo

AU - Yajima, Toshiki

AU - Wada, Naoki

AU - Shirabe, Ken

PY - 2021/9

Y1 - 2021/9

N2 - Background: Sarcopenia is closely associated with morbidity after pancreatic surgery. We investigated the impact of preoperative nutritional support and rehabilitation on patients undergoing pancreaticoduodenectomy. Methods: This was a retrospective analysis of 101 patients who underwent pancreaticoduodenectomy. Skeletal muscle (SM) loss was defined using the SM index (cutoff level: 42 cm2/m2 in men and 38 cm2/m2 in women). A total of 33 and 30 patients received preoperative nutrition and prehabilitation, respectively. The neutrophil-to-lymphocyte ratio (NLR), Prognostic Nutritional Index (PNI), and modified Glasgow Prognostic Score (mGPS) values were calculated during the first visit and immediately before surgery. Results: SM loss was present in 65 of 101 patients and was significantly correlated with female sex, older age, lower body mass index, and low PNI. Preoperative nutritional support and prehabilitation prevented the decrease in PNI values in patients with SM loss. The NLR significantly improved in patients with SM loss who received nutritional support and prehabilitation. In patients with SM loss, the lack of preoperative nutrition and prehabilitation was an independent risk factor for postoperative pancreatic fistula. Conclusions: Preoperative nutritional support and prehabilitation may reduce the incidence of pancreatic fistula in patients with SM loss and improve the surgical outcomes of patients undergoing pancreaticoduodenectomy.

AB - Background: Sarcopenia is closely associated with morbidity after pancreatic surgery. We investigated the impact of preoperative nutritional support and rehabilitation on patients undergoing pancreaticoduodenectomy. Methods: This was a retrospective analysis of 101 patients who underwent pancreaticoduodenectomy. Skeletal muscle (SM) loss was defined using the SM index (cutoff level: 42 cm2/m2 in men and 38 cm2/m2 in women). A total of 33 and 30 patients received preoperative nutrition and prehabilitation, respectively. The neutrophil-to-lymphocyte ratio (NLR), Prognostic Nutritional Index (PNI), and modified Glasgow Prognostic Score (mGPS) values were calculated during the first visit and immediately before surgery. Results: SM loss was present in 65 of 101 patients and was significantly correlated with female sex, older age, lower body mass index, and low PNI. Preoperative nutritional support and prehabilitation prevented the decrease in PNI values in patients with SM loss. The NLR significantly improved in patients with SM loss who received nutritional support and prehabilitation. In patients with SM loss, the lack of preoperative nutrition and prehabilitation was an independent risk factor for postoperative pancreatic fistula. Conclusions: Preoperative nutritional support and prehabilitation may reduce the incidence of pancreatic fistula in patients with SM loss and improve the surgical outcomes of patients undergoing pancreaticoduodenectomy.

KW - Nutrition

KW - Pancreatic fistula

KW - Pancreaticoduodenectomy

KW - Rehabilitation

KW - Sarcopenia

KW - Skeletal muscle loss

UR - http://www.scopus.com/inward/record.url?scp=85107507337&partnerID=8YFLogxK

U2 - 10.1007/s10147-021-01958-0

DO - 10.1007/s10147-021-01958-0

M3 - 学術論文

C2 - 34089094

AN - SCOPUS:85107507337

SN - 1341-9625

VL - 26

SP - 1698

EP - 1706

JO - International Journal of Clinical Oncology

JF - International Journal of Clinical Oncology

IS - 9

ER -

Impact of preoperative nutritional support and rehabilitation therapy in patients undergoing pancreaticoduodenectomy

Abstract

Keywords

ASJC Scopus subject areas

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