Journal of cachexia, sarcopenia and muscle
A Systematic Review and Meta-Analysis of Perioperative Muscle Wasting Following Major Abdominal Surgery
By Reynolds A, George NM, Papadopoulou A and 1 others.
Abstract
Background
Muscle wasting in the perioperative period is a frequent and clinically significant complication following major abdominal surgery and is associated with adverse outcomes, including increased postoperative complications, prolonged hospitalisation and worsened mortality. Despite its prevalence, the magnitude and course of perioperative muscle wasting (POMW) remain incompletely understood, and current interventions are limited. Current definitions applied to sarcopenia do not suitably apply to cohorts undergoing major abdominal surgery, and therefore, we propose the concept of POMW, defined as POMW within 6 weeks of surgery. These systematic review and meta-analysis aim to assess the extent of POMW and synthesise evidence on its clinical impact and potential interventions.
Methods
The electronic databases MEDLINE, EMBASE and Cochrane CENTRAL were searched from their inception to June 2025. Studies with preoperative and postoperative assessments of muscle wasting and/or function within 6 weeks of major abdominal surgery were included. Methodological quality and risk of bias were assessed with the Revised Cochrane model and Newcastle-Ottawa Scale, where appropriate. Meta-analysis was conducted using a random-effects model, with standardised mean changes (SMCs) as effect size metrics. The primary outcome was change in skeletal muscle mass/size within 2 and 6 weeks postoperatively, and the secondary outcome was change in muscle strength.