Title : Significance of sarcopenia and perioperative nutrition therapy in surgery
Abstract:
In my opinion, evaluation and intervention are principles for medical treatment. In the field of surgery, especially in hepato-biliary-pancreatic (HBP), accurate evaluation of physical condition such as sarcopenia and adequate intervention including exercise and nutritional therapy are crucial. We reported that preoperative physical condition evaluated by muscle strength and body compositions such as skeletal muscle mass, muscle quality, and visceral obesity was closely related to outcomes after HBP surgery including hepatectomy for hepatocellular carcinoma, pancreatectomy for pancreas cancer, and living donor liver transplantation (LDLT) for patients with end-stage liver diseases.
In terms of intervention, perioperative nutritional therapy for patients with low skeletal muscle mass significantly improved overall survival in patients undergoing LDLT. As a result, implementation of our new LDLT criteria based on preoperative body compositions with nutritional and exercise intervention for patients with one or two abnormal body composition factors has dramatically improved outcomes after LDLT (1-year overall survival 99%).
Recently, laparoscopic and robotic surgeries, called minimally invasive surgery (MIS), have widely been introduced in gastroenterological surgery. However, the incidence of postoperative complications and the length of the postoperative hospital stay have not decreased significantly after the introduction of such MIS.
In this presentation, we would like to introduce our studies investigating the impact of sarcopenia on outcomes after HBP surgery and our perioperative nutritional and exercise intervention based on preoperative evaluation. From these findings, we can conclude that not chronological age but physical age is closely related to outcomes after surgery. Finally, we would like to discuss “What is real MIS?” from the viewpoint of the patients.
