Cross-sectional areas of rectus abdominis and psoas muscles reduces following surgery in rectal cancer patients

  • Oguz YukselEmail author
  • Naciye Sinem Gezer
  • Aras Emre Canda
  • Hakki Celik
  • Birsu Topcugil
  • Merve Demir Benli
  • Tayfun Bisgin
  • Zumre Arican Alicikus
  • Funda Obuz
Original Article



To evaluate the trophic changes in rectus abdominis and psoas muscles in patients who underwent open or laparoscopic rectum resection for rectal cancer.


We retrospectively analyzed preoperative staging computerized tomographies (CT) and postoperative first oncological follow-up CTs of the patients who underwent low anterior resection (LAR) for rectal cancer from 2010 through 2015. We measured cross-sectional area of left and right rectus abdominis muscles from two levels (above and below umbilicus) where they are widest and psoas muscle at mid-level of the fourth lumbar vertebral body in axial CT images and compared preoperative and postoperative measurements. We investigated the effects of age, sex, administration of preoperative chemoradiotherapy (CRT), type of surgery (open or laparoscopic), or construction of a diverting ileostomy on cross-sectional muscle area changes.


After applying inclusion and exclusion criteria 60 patients found to be eligible for the study. Muscle areas of all measurement sites were reduced postoperatively compared to paired preoperative values. There was no significant effect of age, sex, administration of preoperative CRT, type of surgery (open or laparoscopic), or construction of a diverting ileostomy to muscle cross-sectional area reductions.


Cross-sectional areas of the rectus abdominis and the psoas muscles of rectal cancer patients reduces following rectum resection which indicates atrophy of these muscles. Clinicians should be aware of this problem and focus on prevention of muscle atrophy during the treatment of rectal cancer patients.


Rectal cancer Rectus abdominis Psoas Muscle atrophy Rectum resection surgery 



We would like to thank Professor Hulya Ellidokuz from Dokuz Eylul University School of Medicine, Department of Biostatistics and Medical Informatics, Izmir, Turkey, for reviewing the results and the statistical analysis.

Authors’ contributions

Study concept and design: OY, NSG, AEC, and FO; acquisition of data: OY, NSG, AEC, HC, BT, MDB, and TB; analysis and interpretation of data: OY, NSG, AEC, HC, TB, and ZAA; drafting of the manuscript: OY and AEC; critical revision of the manuscript for important intellectual content: OY, AEC, ZAA, and FO.

Compliance with ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. According to the decision of the medical ethical committees, no informed consent was required.

We agree to allow the journal to review our data if requested.

Ethical approval

The study was reviewed and approved by the institutional research and ethics committee (Dokuz Eylul University, 2764-GOA).

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Sports Medicine, School of MedicineDokuz Eylul UniversityIzmirTurkey
  2. 2.Department of Radiology, School of MedicineDokuz Eylul UniversityIzmirTurkey
  3. 3.Department of Surgery, School of MedicineDokuz Eylul UniversityIzmirTurkey
  4. 4.Department of Radiation Oncology, School of MedicineDokuz Eylul UniversityIzmirTurkey

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