Preoperative phase angle is not associated with postoperative recovery in living liver donors: A prospective observational study

초록

Background: Phase angle (PA) has been proposed as a prognostic factor for evaluating postoperative outcomes across various types of surgery. In this study, we investigated whether preoperative PA measured in living liver donors is associated with postoperative recovery. Methods: Donors aged over 19 years, scheduled for elective purely laparoscopic donor hepatectomy, were included. Each donor underwent bioimpedance analysis (BIA), including PA, on the day before surgery (PApre) and the third postoperative day (PAPOD3) using the InBody S10 (InBody Co., Ltd, Seoul, Korea). Postoperative recovery quality was assessed using the Korean version of the quality of recovery (QoR-15K). All donors completed the QoR-15K on POD3 and POD21 to evaluate their recovery following surgery and anesthesia. Results: The mean age of the participants was 38.7±13.2 years, and 24 male donors (59%) were included. PAPOD3 significantly decreased compared to PApre (5.42±0.97 vs. 5.99±0.76; mean difference: —0.57, p=0.004). The extracellular water ratio (ECWR) on POD3 increased compared to preoperative levels (0.391±0.011 vs. 0.378±0.007; mean difference: 0.013, p<0.001). However, skeletal muscle mass index (SMI) did not significantly change over time (SMIpre: 7.5±1.1; SMIPOD3: 8.0±1.2; p=0.67). Neither PApre nor ECWRpre was associated with QoR-15K scores on POD3. However, SMIpre was significantly associated with QoR-15K on POD3, but not on POD21. In the logistic regression model, preoperative BIA variables were not associated with in-hospital complications. Conclusion: While PApre was not associated with postoperative recovery or complications, a higher SMI was identified as a significant predictor of better recovery, suggesting its potential use as a screening tool in living liver donors.

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