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Effect of the Remnant Stomach Volume on the Nutritional and Body Composition in Stage 1 Gastric Cancer Patients
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Koen Lee, Kyung Won Kim, Jung-Bok Lee, Yongbin Shin, Jin Kyoo Jang, Jeong-Hwan Yook, Byung-Sik Kim, In-Seob Lee
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Surg Metab Nutr 2018;9(2):41-50. Published online December 30, 2018
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DOI: https://doi.org/10.18858/smn.2018.9.2.41
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 Abstract
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Purpose: During the first year after surgery, gastric cancer patients experience weight loss and a decline in physical activity. In addition, depravation of the nutritional status and anemia is observed. The decrease in stomach volume is believed to be one of the causes for these changes. The purpose of this study was to investigate the effects of the remnant stomach volume on nutrition, anemia, and body composition-related parameters in gastric cancer patients after surgery. Materials and Methods: A total of 110 patients with stage 1 gastric cancer, who underwent a laparoscopic gastrectomy in 2015 were evaluated in this prospective observational study. Among them, 78 patients received a distal gastrectomy (Billroth 1: 52, Billroth 2: 12, Roux en Y: 14) and 32 underwent a total gastrectomy. The weight, height, and blood test results of the patients were collected during the observation period. The remnant stomach volume, total abdominal muscle area, and subcutaneous/visceral fat area were measured using CT images. Results: Patients with a larger remnant stomach volume showed a smaller decrease in the nutritional parameters and better recovery of the hemoglobin level during the first year after surgery. Among the body composition parameters, visceral fat was affected to the greatest extent and subcutaneous/visceral fat were better preserved in the group with a larger remnant stomach volume. In the group with a total gastrectomy, the parameters were worsened significantly compared to the distal gastrectomy group. Conclusion: The remnant stomach volume has a protective effect on the body mass index, body weight change, hemoglobin, total protein, cholesterol, and visceral/subcutaneous fat area during the first year after surgery.
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