ArticleJournal of cachexia, sarcopenia and muscle2026
Impact of Thoracic Duct Resection on Postoperative Body Composition Trajectory After Oesophagectomy: A Prospective Cohort Study.
Article in Journal of cachexia, sarcopenia and muscle, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Impact of Thoracic Duct Resection on Postoperative Body Composition Trajectory After Oesophagectomy: A Prospective Cohort Study.Journal of cachexia, sarcopenia and muscle · 2026Article
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7 authors.
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Abstract
backgroundThoracic duct resection (TDR) is frequently performed during radical oesophagectomy to improve locoregional control in oesophageal squamous cell carcinoma (ESCC). However, its impact on postoperative body composition-particularly skeletal muscle mass-remains unclear. This study aimed to evaluate the extent and temporal pattern of postoperative changes in adiposity- and sarcopenia-related indices following TDR.
methodsIn this prospective cohort study, 347 patients with ESCC who underwent curative oesophagectomy between May 2018 and June 2022 were included. Patients were classified into a TDR group (n = 288) and a thoracic duct preservation group (n = 59). Body composition was assessed using bioelectrical impedance analysis (BIA) at six time points: preoperatively and 1, 2, 3, 6 and 12 months postoperatively, yielding 1925 measurements. Metrics analysed included body mass index (BMI), fat mass index (FMI), skeletal muscle mass index (SMI) and fat-free mass index (FFMI). Sensitivity analysis was performed using 1:1 propensity score matching (PSM), based on key clinical variables.
resultsMedian age was 64 years, and ~90% of patients were male in both groups. Baseline operative variables were comparable between groups, including operative time (485 vs. 478 min), total lymph nodes (66 vs. 63) and complication rates (30% vs. 32%). BMI and FMI declined gradually over 12 months with no significant between-group differences (BMI at 12 months: TDR vs. preservation, 21.0 vs. 20.6 kg/m
conclusionsThis is the largest study to date to assess longitudinal body composition changes after TDR using serial BIA. TDR was associated with a greater decline in sarcopenia-related indices, particularly within the first 3 months. These effects were transient, reversible and reproducible in early-stage patients. Our findings support the oncologic role of TDR while underscoring the importance of early nutritional and rehabilitative care.
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