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A Prospective Observational Study Evaluating the Change of Nutritional Status and the Incidence of Dumping Syndrome after Gastrectomy
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Original Article A Prospective Observational Study Evaluating the Change of Nutritional Status and the Incidence of Dumping Syndrome after Gastrectomy
Ju-Ri Na1, Yuhn-Suk Suh1,2, Seong-Ho Kong1,2, Jeong Hyun Lim2,3, Dal-Lae Ju2,3, Han-Kwang Yang1,2,4, Hyuk-Joon Lee1,2,4

위절제술 후 영양 상태의 변화와 덤핑 증후군 발생에 대한 전향적 관찰 연구
나주리1, 서윤석1,2, 공성호1,2, 임정현2,3, 주달래2,3, 양한광1,2,4, 이혁준1,2,4
Journal of Clinical Nutrition 2014;6(2):59-70.
DOI: https://doi.org/10.15747/jcn.2014.6.2.59
Published online: August 30, 2014
1Division of Gastrointestinal Surgery,
2Nutritional Support Team,
3Department of Food Service and Nutrition Care, Seoul National University Hospital,
4Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea

서울대학교병원 1위장관외과,
2영양집중지원팀,
3급식영양과,
4서울대학교 의과대학 외과학교실 및 암연구소
Received: 6 July 2014   • Revised: 1 August 2014   • Accepted: 1 August 2014
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Purpose
The aim of this study was to investigate the change of nutritional status and the incidence of dumping syndrome after gastrectomy for gastric cancer.Methods: From January 2013 to May 2014, 36 patients who underwent gastrectomy for gastric cancer were prospectively investigated in terms of nutritional status by body weight, anthropometric measurements, biochemical data, and Patient-Generated Subjective Global Assessment (PG-SGA). Dumping syndrome was assessed using a newly developed questionnaire based on the Japanese Society of Gastroenterological Surgery survey and Sigstad’s scoring system. Results: Body weight losses were 4.6%, 8.1%, and 6.9% at discharge, six months, and one year after discharge, respectively. Triceps skinfold thickness had no significance, however, mid-arm muscle circumference showed significant loss after gastrectomy. A part of the biochemical data showed significant change after gastrectomy, but almost indicated a restoring tendency within two months after discharge. In terms of PG-SGA, 33 patients (91.7%) were classified as A (well-nourished) before surgery, however, the number of well-nourished patients showed a sharp decrease to 1 (2.8%) at two weeks after discharge, and then gradually increased to 25 (69.4%) at one year. The main obstacles against diet intake were reported as ‘early satiety’ and ‘anxiety’. The number of patients who had experience in at least one dumping syndrome related symptom was 21 (58.3%) at discharge, 26 (72.2%) at two months after discharge, and 11 (30.6%) at one year after discharge. Conclusion: Nutritional deficit as well as dumping syndrome is encountered in a large number of gastric cancer patients after gastrectomy. Postoperative nutritional support and personalized education seem to be very important during the postoperative period.


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