Effects of nutritional prehabilitation on skeletal muscle mass and postoperative complications in patients who undergo major hepatectomy after portal vein embolization

Abstract

Aim: The effects of nutritional prehabilitation (NP) on the rate of change in skeletal muscle index (SMI) and postoperative outcomes were investigated. Methods: The study subjects included 99 patients who underwent major hepatectomy after portal vein embolization between September 2008 and May 2019. Clinical variables and the rate of change in preoperative SMI were compared between patients with and without NP. Among the patients who underwent NP, the occurrence of postoperative complications was compared between those with increased and decreased SMI. Results: The rate of change in SMI was higher in patients with NP (n=30) than in those without NP (n=69) (median ＋1.8％ vs. ＋0.1％, P=0.038). Among the patients who underwent NP, the occurrence of postoperative organ/space surgical site infection (14％ vs. 56％, P=0.032) and liver failure (14％ vs. 56％, P=0.032) was lower and length of hospitalization was shorter (17 days vs. 24 days, P=0.033) in patients with increased SMI (n=21) than in those with decreased SMI (n=9). Conclusion: NP was considered to be a useful strategy to increase SMI and reduce postoperative complications.