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Comparison of Post-Operative Nutritional Status according to the Extent of Gastrectomy and the Reconstruction Method in Patients with Gastric Cancer
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Kyung Hwan Kim, Jong Hyuk Yoon, Geum Jong Song, Myoung Won Son, Sung Yong Kim, Moo Jun Baek, Moon Soo Lee
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Ann Clin Nutr Metab 2021;13(2):34-42. Published online December 31, 2021
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DOI: https://doi.org/10.15747/ACNM.2021.13.2.34
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- Purpose: Malnutrition is the main complication after gastrectomy and the degree may vary depending on the extent of resection. This study sought to help determine an appropriate type of resection and provide methods for addressing malnutrition after gastrectomy.
Materials and Methods: We retrospectively reviewed medical records of patients with gastric cancer who underwent radical resection at the Soonchunhyang University Cheonan Hospital between December 2012 and December 2013. A total of 100 patients were screened, and all patients were followed for 1 to 3 years. Among this group, 12 underwent total gastrectomy, 5 underwent proximal gastrectomy, 46 underwent distal gastrectomy with Billroth I anastomosis, and 37 with Billroth II anastomosis. The nutritional status assessment included body weight, body mass index, serum albumin, serum hemoglobin, vitamin B12, ferritin, and Nutritional Risk Index (NRI).
Results: Patients who underwent total gastrectomy had lower hemoglobin and vitamin B12 levels compared to patients who underwent distal gastrectomy. The NRI was statistically significantly lower in patients who underwent total gastrectomy than patients who underwent distal gastrectomy. Patients who underwent total gastrectomy had lower vitamin B12 than patients who underwent proximal gastrectomy till the second year after gastrectomy. Regarding postdistal gastrectomy reconstruction, there was no statistically significant difference between the Billroth I and Billroth II groups.
Conclusion: This study showed that patients who underwent total gastrectomy were more susceptible to malnutrition than those who underwent distal or proximal gastrectomy. Patients who undergo gastrectomy should be monitored carefully for nutritional status and given appropriate nutritional support in the post-operative period.
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Effect of Total Parenteral Nutrition Therapy in Palliative Gastrojejunostomy Status Patients
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Yung Kil Kim, Geum Jong Song, Tae Sung Ahn, Myoung Won Son, Sun Wook Han, Joon-Hwan Song, Ho Kim, Sang Ho Bae, Sung Yong Kim, Moo Jun Baek, Moon Soo Lee
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Surg Metab Nutr 2018;9(1):26-30. Published online June 30, 2018
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DOI: https://doi.org/10.18858/smn.2018.9.1.26
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Purpose: Gastric outlet obstruction (GOO) is a common problem associated with advanced malignancies of the upper gastrointestinal tract. Adverse events, such as malnutrition, can affect the quality of life, and gastrojejunostomy can be performed for palliative care. This study evaluated effects of total parenteral nutrition (TPN) therapy in post-operation state patients who underwent a palliative gastrojejunostomy (PGJ). Materials and Methods: Between January 2011 and June 2015, a total of 65 patients underwent PGJ at Soonchunhyang University Cheonan Hospital and all consecutive patients were included in this retrospective study. All patients were divided into the preoperative TPN group and non-TPN group. A nutritional status assessment included the body weight (BW), body mass index (BMI), CRP level, serum albumin, serum total protein, hemoglobin, and total lymphocyte count (TLC). Results: Thirty-one patients did not receive the TPN treatment, and 34 patients received the TPN treatment before surgery. Significant differences between preoperative and postoperative BW, BMI, CRP level, serum albumin, serum total protein, hemoglobin, and TLC were observed in the non-TPN group. On the other hand, there was no significant difference between the preoperative BW, BMI, TLC and postoperative BW, BMI, TLC in the TPN group (p=0.914, p=0.873, p=0.319). Conclusion: These results suggest that preoperative TPN therapy can improve the nutritional status in patients who underwent PGJ.
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Association of Nutrition Status-Related Indices and XELOX Chemotherapy Compliance in Gastric Cancer Patients
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Sang Hyun Park, Geum Jong Song, Myoung Won Son, Sun Wook Han, Sang Ho Bae, Sung Yong Kim, Moo Jun Baek, Moon Soo Lee
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Surg Metab Nutr 2017;8(2):36-40. Published online December 30, 2017
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DOI: https://doi.org/10.18858/smn.2017.8.2.36
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Purpose:Cancer-associated malnutrition is common in gastric cancer patients and affects their response to treatment. This study evaluated pre-operative and pre-chemotherapy nutritional status-related indices associated with compliance in post-operation state gastric cancer patients receiving chemotherapy. Materials and Methods:We retrospectively reviewed medical records of patients with gastric cancer undergoing curative D2 resection between August 2014 and July 2016. A total of 51 patients who underwent adjuvant chemotherapy with a regimen of capecitabine and oxaliplatin (XELOX) were screened. Nutritional status assessment included body weight (BW), body mass index (BMI), serum albumin, serum total protein, hemoglobin, and total lymphocyte count (TLC). Results:Twenty-six patients had stage II gastric cancer, and 25 patients had stage Ⅲ gastric cancer according to the guidelines of the American Joint Committee on Cancer. Eighty-two percent of patients completed their chemotherapy according to the therapy protocol. However, 49% of patients were subjected to drug dose reduction, and 18% of patients needed to cease therapy. We found that pre-chemotherapy serum albumin level was significantly associated with completion of chemotherapy (P=0.043), and there was no significant relationship of BW, BMI, serum total protein, hemoglobin, and TLC with compliance of chemotherapy. Conclusion:Our study results suggest that patients with a low serum albumin level are highly susceptible to discontinuation of chemotherapy. Thus, serum albumin concentration could be used as a predictor of successful completion of chemotherapy before starting treatment.
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