Surgical Stress Evaluation of Left Lateral Sectionectomy Based on Skeletal Muscle Catabolism

Background: By examining skeletal muscle catabolism, we aimed to investigate whether laparoscopic left lateral sectionectomy (LLS) is less invasive compared with the open approach.

Methods: The psoas muscle index (PMI) was measured using computed tomography images before and after surgery. We assessed the relationship between the perioperative PMI reduction rate and the estimation of physiologic ability and surgical stress (E-PASS) score and then compared the PMI reduction rates associated with different approaches.

Results: Of the 31 patients, 13 and 18 underwent the open and laparoscopic approaches, respectively. A strong correlation was observed between the PMI reduction rates and surgical stress scores (SSS) ( r =0.561, P <0.01). The laparoscopic approach was associated with a significantly lower PMI reduction rate ( P <0.01) and SSS ( P <0.01) than the open approach.

Conclusion: Laparoscopic LLS should be less invasive than the open approach from the perspective of not only perioperative outcomes but also skeletal muscle catabolism.