Body composition assessment by artificial intelligence can be a predictive tool for short-term postoperative complications in Hartmann’s reversals

Abstract Background Hartmann's reversal, a complex elective surgery, reverses and closes the colostomy in individuals who previously underwent a Hartmann's procedure due to colonic pathology like cancer or diverticulitis. It demands careful planning and patient optimisation to help reduce...

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Main Authors: Reshi Suthakaran, Ke Cao, Yasser Arafat, Josephine Yeung, Steven Chan, Mobin Master, Ian G. Faragher, Paul N. Baird, Justin M. C. Yeung
Format: Article
Language:English
Published: BMC 2024-04-01
Series:BMC Surgery
Subjects:
Online Access:https://doi.org/10.1186/s12893-024-02408-0
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author Reshi Suthakaran
Ke Cao
Yasser Arafat
Josephine Yeung
Steven Chan
Mobin Master
Ian G. Faragher
Paul N. Baird
Justin M. C. Yeung
author_facet Reshi Suthakaran
Ke Cao
Yasser Arafat
Josephine Yeung
Steven Chan
Mobin Master
Ian G. Faragher
Paul N. Baird
Justin M. C. Yeung
author_sort Reshi Suthakaran
collection DOAJ
description Abstract Background Hartmann's reversal, a complex elective surgery, reverses and closes the colostomy in individuals who previously underwent a Hartmann's procedure due to colonic pathology like cancer or diverticulitis. It demands careful planning and patient optimisation to help reduce postoperative complications. Preoperative evaluation of body composition has been useful in identifying patients at high risk of short-term postoperative outcomes following colorectal cancer surgery. We sought to explore the use of our in-house derived Artificial Intelligence (AI) algorithm to measure body composition within patients undergoing Hartmann’s reversal procedure in the prediction of short-term postoperative complications. Methods A retrospective study of all patients who underwent Hartmann's reversal within a single tertiary referral centre (Western) in Melbourne, Australia and who had a preoperative Computerised Tomography (CT) scan performed. Body composition was measured using our previously validated AI algorithm for body segmentation developed by the Department of Surgery, Western Precinct, University of Melbourne. Sarcopenia in our study was defined as a skeletal muscle index (SMI), calculated as Skeletal Muscle Area (SMA) /height2 < 38.5 cm2/m2 in women and < 52.4 cm2/m2 in men. Results Between 2010 and 2020, 47 patients (mean age 63.1 ± 12.3 years; male, n = 28 (59.6%) underwent body composition analysis. Twenty-one patients (44.7%) were sarcopenic, and 12 (25.5%) had evidence of sarcopenic obesity. The most common postoperative complication was surgical site infection (SSI) (n = 8, 17%). Sarcopenia (n = 7, 87.5%, p = 0.02) and sarcopenic obesity (n = 5, 62.5%, p = 0.02) were significantly associated with SSIs. The risks of developing an SSI were 8.7 times greater when sarcopenia was present. Conclusion Sarcopenia and sarcopenic obesity were related to postoperative complications following Hartmann’s reversal. Body composition measured by a validated AI algorithm may be a beneficial tool for predicting short-term surgical outcomes for these patients.
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spelling doaj.art-49b245325f904e0f9df224c83b8fe4d12024-04-21T11:07:21ZengBMCBMC Surgery1471-24822024-04-012411810.1186/s12893-024-02408-0Body composition assessment by artificial intelligence can be a predictive tool for short-term postoperative complications in Hartmann’s reversalsReshi Suthakaran0Ke Cao1Yasser Arafat2Josephine Yeung3Steven Chan4Mobin Master5Ian G. Faragher6Paul N. Baird7Justin M. C. Yeung8Department of Colorectal SurgeryDepartment of Surgery, Western Precinct, University of MelbourneDepartment of Colorectal SurgeryDepartment of Surgery, Western Precinct, University of MelbourneDepartment of Surgery, Western Precinct, University of MelbourneDepartment of RadiologyDepartment of Colorectal SurgeryDepartment of Surgery, Western Precinct, University of MelbourneDepartment of Colorectal SurgeryAbstract Background Hartmann's reversal, a complex elective surgery, reverses and closes the colostomy in individuals who previously underwent a Hartmann's procedure due to colonic pathology like cancer or diverticulitis. It demands careful planning and patient optimisation to help reduce postoperative complications. Preoperative evaluation of body composition has been useful in identifying patients at high risk of short-term postoperative outcomes following colorectal cancer surgery. We sought to explore the use of our in-house derived Artificial Intelligence (AI) algorithm to measure body composition within patients undergoing Hartmann’s reversal procedure in the prediction of short-term postoperative complications. Methods A retrospective study of all patients who underwent Hartmann's reversal within a single tertiary referral centre (Western) in Melbourne, Australia and who had a preoperative Computerised Tomography (CT) scan performed. Body composition was measured using our previously validated AI algorithm for body segmentation developed by the Department of Surgery, Western Precinct, University of Melbourne. Sarcopenia in our study was defined as a skeletal muscle index (SMI), calculated as Skeletal Muscle Area (SMA) /height2 < 38.5 cm2/m2 in women and < 52.4 cm2/m2 in men. Results Between 2010 and 2020, 47 patients (mean age 63.1 ± 12.3 years; male, n = 28 (59.6%) underwent body composition analysis. Twenty-one patients (44.7%) were sarcopenic, and 12 (25.5%) had evidence of sarcopenic obesity. The most common postoperative complication was surgical site infection (SSI) (n = 8, 17%). Sarcopenia (n = 7, 87.5%, p = 0.02) and sarcopenic obesity (n = 5, 62.5%, p = 0.02) were significantly associated with SSIs. The risks of developing an SSI were 8.7 times greater when sarcopenia was present. Conclusion Sarcopenia and sarcopenic obesity were related to postoperative complications following Hartmann’s reversal. Body composition measured by a validated AI algorithm may be a beneficial tool for predicting short-term surgical outcomes for these patients.https://doi.org/10.1186/s12893-024-02408-0Colorectal surgerySarcopenic obesityBody composition
spellingShingle Reshi Suthakaran
Ke Cao
Yasser Arafat
Josephine Yeung
Steven Chan
Mobin Master
Ian G. Faragher
Paul N. Baird
Justin M. C. Yeung
Body composition assessment by artificial intelligence can be a predictive tool for short-term postoperative complications in Hartmann’s reversals
BMC Surgery
Colorectal surgery
Sarcopenic obesity
Body composition
title Body composition assessment by artificial intelligence can be a predictive tool for short-term postoperative complications in Hartmann’s reversals
title_full Body composition assessment by artificial intelligence can be a predictive tool for short-term postoperative complications in Hartmann’s reversals
title_fullStr Body composition assessment by artificial intelligence can be a predictive tool for short-term postoperative complications in Hartmann’s reversals
title_full_unstemmed Body composition assessment by artificial intelligence can be a predictive tool for short-term postoperative complications in Hartmann’s reversals
title_short Body composition assessment by artificial intelligence can be a predictive tool for short-term postoperative complications in Hartmann’s reversals
title_sort body composition assessment by artificial intelligence can be a predictive tool for short term postoperative complications in hartmann s reversals
topic Colorectal surgery
Sarcopenic obesity
Body composition
url https://doi.org/10.1186/s12893-024-02408-0
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