Sarcopenia and perioperative infectious complications : current status and future perspectives (review)

Abstract

Sarcopenia, characterized by a decline in skeletal muscle mass and muscle strength or physical activity, is now accepted worldwide as a new geriatric syndrome. Recent studies have identified significant associations between preoperative sarcopenia and poor outcomes after various surgeries. This article reviews current status of sarcopenia and perioperative infectious complications mainly in hepato-biliary-pancreatic surgery and liver transplantation. Aging causes primary sarcopenia, and other conditions such as disuse, malnutrition, organ failure, cancer and surgery itself cause secondary sarcopenia. Most patients who undergo major surgery present with a number of these factors related to sarcopenia. Moreover, due to arrival of the super-aging society, more elderly patients will undergo surgery. Therefore, the significance of sarcopenia for patients undergoing surgery will be more and more important. In my opinion, evaluation and intervention are principles for medical treatment. In the field of rehabilitation and nutritional therapy, accurate evaluation and adequate intervention are crucial. Therefore, not uniform but tailor-made adequate intervention for selected patients is highly recommended considering limited resources and would be a breakthrough to improve outcomes after surgery. In this review, we would like to introduce our perioperative nutritional and exercise intervention based on preoperative evaluation for better outcomes in St Luke’s International Hospital.