Nutritional Status after Curative Surgery in Patients with Gastric Cancer: Comparison of Total Versus Subtotal Gastrectomy

Yu, Wansik; Chung, Ho Young

Abstract

PURPOSE: We compared patient nutritional status following both total gastrectomy and subtotal gastrectomy in order to identify the effect of the extent of gastric resection on nutritional outcome and to provide methods for improving malnutrition. METHODS: We studied 238 patients with no evidence of recurrent disease following curative surgery for gastric cancer. Among this group, 45 underwent total gastrectomy (TG) and 193 subtotal gastrectomy (SG). The nutritional status was assessed by measuring hemoglobin, serum albumin, iron and vitamin B12, as well as calculating relative body weight, body mass index and percent body fat. RESULTS: Regardless of the extent of gastric resection, most patients revealed a low hemoglobin level and more than 80% of patients demonstrated anemia. Serum iron level was lower in the TG group than in the SG group at one year after surgery (p=0.027), and 80.0% of the TG group revealed a low serum iron level (less than 65 ug/mL) as compared to 25.6% of the SG group at three years after surgery (p=0.001). Serum vitamin B12 level of the TG group was lower than that of the SG group. There was a tendency of lower relative body weight, lower body mass index and lower percent body fat in the TG group than in the SG group. CONCLUSION: Periodic nutritional assessment is recommended following gastrectomy and nutrients including iron and vitamin B12 must be supplemented when indicated.