Document Detail

Nutritional status of gastric cancer patients after total gastrectomy.
MedLine Citation:
PMID:  9494417     Owner:  NLM     Status:  MEDLINE    
A number of causes of malnutrition after total gastrectomy have been proposed. The purpose of this study was to assess nutritional status and to determine the cause of malnutrition after total gastrectomy. We studied 20 gastric cancer patients who had undergone total gastrectomy and immunochemotherapy and 6 normal controls. Nutritional status was assessed by dietary history, anthropometric methods, and serologic measurements. Malabsorption tests included the fecal fat excretion test, D-xylose absorption test, glucose tolerance test, vitamin B12 absorption test using dual isotopes, bacterial culture of jejunal aspirates, and jejunal biopsy. Weight loss was compared to the preoperative status in all patients (average 15%: 59.0 +/- 9.9 vs. 50.2 +/- 7.8 kg, preoperatively vs. postoperatively). Average daily calorie intake was 1586.2 kcal, which is lower than the normal intake of Korean adults (1838 kcal). Malnutrition of skeletal and visceral protein was not found. There was, however, severe fat malnutrition and a deficit of body fat. Postoperatively the body mass index was considerably lower than that preoperatively (22.2 +/- 0.4 vs. 18.9 +/- 0.4 kg/m2; preoperatively vs. postoperatively). With malabsorption tests, the daily excreted amount of fecal fat was 28.6 +/- 3.4 g (mean +/- SD) in patients and 6.9 +/- 0.2 g in controls. There was no significant malabsorption of carbohydrates. In 64.3% (9/14) of patients, vitamin B12 absorption was abnormal; and the serum concentration of vitamin B12, which was significantly related to malabsorption of this vitamin, was lower than normal in 73.7% (14/19). Bacterial overgrowth was not found, and there were no abnormal histologic findings in the jejunal mucosa. These results suggest that poor oral intake and fat malabsorption following total gastrectomy cause malnutrition and that fat malabsorption may be related to relative pancreatic insufficiency.
J M Bae; J W Park; H K Yang; J P Kim
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of surgery     Volume:  22     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  1998 Mar 
Date Detail:
Created Date:  1998-04-21     Completed Date:  1998-04-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  254-60; discussion 260-1     Citation Subset:  IM    
Department of Surgery, College of Medicine, Ewha Women's University Mokdong Hospital, Seoul, Korea.
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MeSH Terms
Body Weight
Energy Intake
Glucose Tolerance Test
Jejunum / microbiology
Middle Aged
Nutrition Disorders / etiology
Nutritional Status*
Postoperative Complications
Stomach Neoplasms / surgery*
Vitamin B 12 / metabolism
Xylose / diagnostic use
Reg. No./Substance:
0/Xylose; 68-19-9/Vitamin B 12
Comment In:
World J Surg. 1999 Sep;23(9):983-4   [PMID:  10449833 ]
Erratum In:
World J Surg 1998 Aug;22(8):903

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