The Influence of Preoperative Sarcopenia on Perioperative Nutritional Status Changes in Laparoscopic Liver Resection: A Single-Institution Retrospective Analysis

Background: The preoperative sarcopenia is reported to be strongly associated with postoperative worse outcomes, but few reports have addressed how the surgical stress impacts on the sarcopenic patients in the nutritional aspect. In this study, we aimed to clarify the nutritional status change after laparoscopic liver resection focusing on preoperative sarcopenia. Methods: This study is a retrospective study of constitutive 42 patients who received laparoscopic liver resection between July 2018 and Dec 2019 in our single institute. The perioperative nutritional status change and body composition were assessed by blood test and Bioelectrical Impedance Analysis (BIA) with InBody 770. Results: The patients were divided into sarcopenic patients (N=14) and non-sarcopenic patients (N=28). There was no significant difference in the patient background except for age. Although the blood tests showed similar preoperative nutritional results in two groups, BIA showed that sarcopenic patients had less BMI with undeveloped skeletal lean mass at every part than nonsarcopenic patients. According to the postoperative blood tests, it appeared laparoscopic liver resection did not negatively impact sarcopenic patients in contrast that non-sarcopenic patients showed postoperative nutritional deterioration. Of note, BIA found out that the only sarcopenic patients lost upper/lower body balance due to markedly reduced lower extremity lean mass. Conclusion: This result suggested the importance of targeting lower extremity development for balanced body composition for the sarcopenic patients who receive laparoscopic liver resection before surgery.