<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2341-4545</journal-id>
<journal-title><![CDATA[GE-Portuguese Journal of Gastroenterology]]></journal-title>
<abbrev-journal-title><![CDATA[GE Port J Gastroenterol]]></abbrev-journal-title>
<issn>2341-4545</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Gastrenterologia]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2341-45452021000100013</article-id>
<article-id pub-id-type="doi">10.1159/000507206</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Body Composition Influences Post-Operative Complications and 90-Day and Overall Survival in Pancreatic Surgery Patients]]></article-title>
<article-title xml:lang="pt"><![CDATA[A composição corporal influencia a taxa de complicações pós-operatórias, a sobrevivência aos 90 dias e global em doentes submetidos a cirurgia pancreática]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Velho]]></surname>
<given-names><![CDATA[Sónia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Santos]]></surname>
<given-names><![CDATA[Maria Pia Costa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cunha]]></surname>
<given-names><![CDATA[Cátia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Agostinho]]></surname>
<given-names><![CDATA[Lisa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cruz]]></surname>
<given-names><![CDATA[Rita]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Costa]]></surname>
<given-names><![CDATA[Filipe]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Garcia]]></surname>
<given-names><![CDATA[Mafalda]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Oliveira]]></surname>
<given-names><![CDATA[Paulo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Maio]]></surname>
<given-names><![CDATA[Rui]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Baracos]]></surname>
<given-names><![CDATA[Vickie E.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cravo]]></surname>
<given-names><![CDATA[Marília]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A7"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Beatriz Ângelo Dietetics and Nutrition ]]></institution>
<addr-line><![CDATA[Loures ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Beatriz Ângelo Gastroenterology ]]></institution>
<addr-line><![CDATA[Loures ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Beatriz Ângelo Surgery ]]></institution>
<addr-line><![CDATA[Loures ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital Beatriz Ângelo Radiology ]]></institution>
<addr-line><![CDATA[Loures ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Hospital da Luz Oncology ]]></institution>
<addr-line><![CDATA[Lisboa ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,University of Alberta  ]]></institution>
<addr-line><![CDATA[Edmonton AB]]></addr-line>
<country>Canada</country>
</aff>
<aff id="Af7">
<institution><![CDATA[,Universidade de Lisboa Faculdade de Medicina ]]></institution>
<addr-line><![CDATA[Lisboa ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>27</day>
<month>02</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>27</day>
<month>02</month>
<year>2021</year>
</pub-date>
<volume>28</volume>
<numero>1</numero>
<fpage>13</fpage>
<lpage>25</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2341-45452021000100013&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2341-45452021000100013&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2341-45452021000100013&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction: Pancreatic surgery still carries a high morbidity and mortality even in specialized centers. The aim of this study was to evaluate the influence of patients&#8217; body composition on postoperative complications and survival after pancreatic surgery.  Methods: This was a retrospective study on patients undergoing pancreatic surgery between March 2012 and December 2017. Demographics, clinical data, and postoperative complications classified according to Clavien-Dindo were recorded. Body composition was assessed using routine diagnostic or staging computed tomography (CT). Multiple Cox proportional hazards models were adjusted.  Results: Ninety patients were included, 55% were male, and the mean age was 68 ± 10.9 years. Of these 90, 92% had a total pancreatectomy or pancreaticoduodenectomy, 7% a distal pancreatectomy, and 1% a pancreaticoduodenectomy with multi-visceral resection; 84% had malignant disease. The incidence of major complications was 27.8% and the 90-day mortality was 8.8%. The ratio of visceral fat area/skeletal muscle area (VFA:SMA) was associated with an increased risk of complications (OR 2.24, 95% CI 1.14-4.87, p = 0.03) and 90-day survival (HR 2.13, 95% CI 1.13-4.01, p = 0.019). On simple analysis, shorter overall survival (OS) was observed in patients aged &#8805;70 years (p = 0.0009), with postoperative complications &#8805;IIIb (p = 0.01), an increased VFA:SMA (p = 0.007), and decreased muscle radiation attenuation (p = 1.6 × 10-5). In an OS model adjusted for age, disease malignancy, postoperative complications, and body composition parameters, muscle radiation attenuation remained significantly associated with survival (HR 0.94, 95% CI 0.90-0.98, p = 0.0016). A model which included only body composition variables had a discrimination ability (C-statistic 0.76) superior to a model which comprised conventional clinical variables (C-statistic 0.68).  Conclusion: Body composition is a major determinant of postoperative complications and survival in pancreatic surgery patients.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo:  Introdução: A cirurgia pancreática continua associada a uma elevada morbimortalidade mesmo em centros de referência. O objetivo do presente estudo foi avaliar a influência da composição corporal nas complicações e sobrevivência após cirurgia pancreática.  Métodos: Estudo retrospetivo em doentes submetidos a cirurgia pancreática entre Março 2012 e Dezembro 2017. Foram registadas variáveis demográficas, clínicas, complicações pós-cirúrgicas classificadas de acordo com a classificação de a classificação de Clavien Dindo. A composição corporal foi avaliada utilizando imagens de Tomografia Axial Computorizada (TAC) realizada no diagnóstico. Modelos de riscos porporcionais de Cox foram ajustados.  Resultados: Incluídos 90 doentes, 55% homens e média de idade de 68 ± 10.9 anos; 92% submetidos a pancreatectomia/pancreatoduodenectomia, 7% pancreatectomia distal e 1% pancreatoduodenectomia com ressecção multivisceral; 84% tinham doença maligna. A incidência de complicações major foi de 27.8% e a mortalidade aos 90 dias de 8.8%. O racio da Área de Gordura Visceral (AGV) / Área de Tecido Muscular Esquelético (ATME) associou-se a um risco acrescido de complicações (OR 2.24, 95% CI 1.14-4.87, p = 0.03) e de morte aos 90 dias (HR 2.13, 95% CI 1.13-4.01, p = 0.019). Observámos uma sobrevivência global mais baixa em doentes com idade &#8805;70 anos (p = 0.0009), com complicações &#8805;IIIb (p = 0.01), com AGV/ ATME aumentada e atenuação muscular diminuída (p = 1.6 × 10-5). A atenuação muscular ajustada para a idade, malignidade, complicações, manteve-se associada à sobrevivência global (HR 0.94, IC 95% 0.90-0.98, p = 0.0016). Um modelo que inclua apenas variáveis de composição corporal mostrou uma capacidade discriminatória (C-statistic 0.76) superior a um modelo convencional com variáveis clínicas (C-statistic 0.68).  Conclusão: A composição corporal é um determinante major de complicações pós-cirúrgicas e de sobrevivência de doentes submetidos a cirurgia pancreática.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Pancreatic surgery]]></kwd>
<kwd lng="en"><![CDATA[Body composition]]></kwd>
<kwd lng="en"><![CDATA[Survival]]></kwd>
<kwd lng="en"><![CDATA[Postoperative complications]]></kwd>
<kwd lng="en"><![CDATA[Muscle attenuation]]></kwd>
<kwd lng="en"><![CDATA[Ratio of visceral fat area/skeletal muscle area]]></kwd>
<kwd lng="pt"><![CDATA[Cirurgia pancreática]]></kwd>
<kwd lng="pt"><![CDATA[Composição corporal]]></kwd>
<kwd lng="pt"><![CDATA[Sobrevivência]]></kwd>
<kwd lng="pt"><![CDATA[Complicações pós-operatórias]]></kwd>
<kwd lng="pt"><![CDATA[Atenuação muscular]]></kwd>
<kwd lng="pt"><![CDATA[Racio da área de gordura visceral/área de tecido muscular esquelético]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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