Annals of Clinical Nutrition and Metabolism

Complications and Prevention of the Parenteral Nutritional Support in the Intensive Care Unit: Ji Young Jang, Seung Hwan Lee, Jae Gil Lee; Surg Metab Nutr 2013;4(1):1-5. Published online June 30, 2013

Abstract PDF: Nutritional support is one of the therapeutic modalities in the intensive care unit (ICU). Recently enteral feeding is recommended to start as soon as possible especially within 24 or 48 hours after admission. However, parenteral nutrition is important methods for nutritional support in patients who contraindicated for enteral feeding. During nutritional support, complications may occur regardless of methods. In parenteral nutrition, catheter related or metabolic complications are developed. Sometimes serious complications can occur. So, we have to understand the associated complications and try to prevent and detect earlier to manage them. (SMN 2013;4:1-5)

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The Importance of Glycemic Control in Critically Ill Surgical Patients: Jae Myeong Lee; Surg Metab Nutr 2013;4(1):6-9. Published online June 30, 2013

Abstract PDF: (SMN 2013;4:6-9)

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The Studies of Glutamine: Mi Jin Jung, Baik Hwan Cho; Surg Metab Nutr 2013;4(1):10-13. Published online June 30, 2013

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Association of Preoperative Nutritional Factors with Prognosis in Gastric Cancer Patients: Myoung Won Son, Moon Soo Lee; Surg Metab Nutr 2013;4(1):14-17. Published online June 30, 2013

Abstract PDF: Purpose: In gastric cancer patients, nutritional status is known to be associated with postoperative complications and prognosis after surgical treatment. The aim of this study was to examine preoperative nutritional status and several biochemical laboratory tests in gastric cancer patients, and to evaluate whether they are associated with prognosis.
Materials and Methods: Between January 2008 and December 2009, 230 patients who had undergone surgical operation for gastric cancer were enrolled. The nutritional assessment was assessed by the 1st and 2nd nutritional assessment tool. Body mass index, serum albumin, total lymphocyte count, hemoglobin, hematocrit, blood urea nitrogen, creatinine, and cholesterol were examined, and we analyzed whether these factors are associated with prognosis.
Results: A total of 230 patients were included: 174 males and 56 females with a mean age of 60.5 years old. In multivariate analysis, blood urea nitrogen (P<0.001), 2nd nutritional assessment (P=0.001), body mass index (P=0.001), and serum albumin level (P=0.010) were prognostic factors on overall survival.
Conclusion: Preoperative blood urea nitrogen, 2nd nutritional assessment, body mass index, and serum albumin level are prognostic factors for gastric cancer. (SMN 2013;4:14-17)

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Diabetic Status after Radical Gastrectomy in Gastric Cancer Patients with Type 2 Diabetes Mellitus: Ji Yeon Park, Yong Jin Kim; Surg Metab Nutr 2013;4(1):18-23. Published online June 30, 2013

Abstract PDF: Purpose: Bariatric surgery has proven to be effective in weight reduction as well as diabetes resolution. The purpose of this retrospective study was to evaluate the factors related to diabetic remission after radical gastrectomy and to determine the effect of different reconstruction methods on metabolic control in non-obese patients with type 2 diabetes mellitus (T2DM) who underwent surgery for gastric cancer.
Materials and Methods: Patients who underwent radical gastrectomy for histologically proven gastric cancer between January 2005 and December 2012 at Soonchunhyang University Seoul hospital were retrospectively reviewed. Among them, 51 patients diagnosed with T2DM at the time of surgery were enrolled in this study. Pre- and postoperative fasting blood sugar (FBS), serum hemoglobin A1c level, and diabetic medication requirements were obtained and analyzed for determination of the patients’ diabetic status.
Results: During the mean follow-up period of 26±21 months, 12 patients (23.5%) showed diabetic remission, 15 (29.4%) showed improvement, and 24 patients (47.1%) showed the same or worse status of diabetes. Diabetic remission showed significant correlation with the type of reconstruction, duodenal exclusion, duration of diabetes, and preoperative FBS concentration (P=0.038, 0.022, 0.018 and 0.017, respectively). No correlation was observed between surgical extent, BMI change or follow-up period after surgery and postoperative diabetic status. In 37 patients who underwent duodenal bypass, FBS concentration showed a significant decrease, from 137±47 mg/dl to120±28 mg/dl after surgery (P=0.017).
Conclusion: Duodenal exclusion appears to have some influence on diabetic remission beyond weight loss in non-obese gastric cancer patients. Selection of a procedure with duodenal bypass after gastrectomy for gastric cancer patients with T2DM might be reasonable with regard to better glycemic control. (SMN 2013;4:18-23)

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