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Long-Term Trends in Hematological and Nutritional Status After Gastrectomy for Gastric Cancer

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

This study investigated long-term trends in hematological and nutritional parameters after gastrectomy for gastric cancer and evaluated the influence of the reconstruction type on these trends.

Methods

The medical records of 558 patients who underwent curative gastrectomy with standard lymph node dissection for stage I gastric cancer between January 2006 and December 2013 were reviewed. The hematological and nutritional parameters evaluated included hemoglobin, ferritin, vitamin B12, total protein, albumin, total cholesterol, triglyceride, and calcium. The patients were followed up for 6 months postoperatively and then annually until death, cancer recurrence, or follow-up loss.

Results

In the long term, ferritin and triglyceride gradually decreased after gastrectomy, while the other parameters decreased slightly or were stable. In the comparisons according to reconstruction type, the Roux-en-Y group had the lowest levels of hemoglobin, ferritin, vitamin B12, total protein, albumin, and total cholesterol beginning 6 months postoperatively compared with the Billroth I and II groups. However, only ferritin and vitamin B12 had significant differences in the 5-year cumulative incidences of deficiency/reduction according to the reconstruction type, whereas albumin, triglyceride, total cholesterol, and calcium did not.

Conclusions

Although malabsorption and malnutrition are common in patients after a gastrectomy, most nutritional parameters were stable or decreased slightly in the long-term and were not markedly influenced by the reconstruction type or extent of gastrectomy. Therefore, for more accurate nutritional assessment after gastrectomy, multidirectional monitoring should be considered rather than simply measuring biochemical parameters.

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Acknowledgements

The statistical consultation was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI14C1062).

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Authors and Affiliations

  1. Department of Surgery, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Ji-Hyun Kim, You-Jin Bae, Kyong-Hwa Jun & Hyung-Min Chin

  2. 93-6, Jidong, Paldal-gu, Suwon, Gyeonggi-do, 442-723, Republic of Korea

    Kyong-Hwa Jun

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Contributions

JK, YB, KJ, and HC contributed and were involved in the conception/design of the study. JK and YB collected and analyzed the data. JK and KJ wrote the manuscript. KJ and HC assisted in drafting the manuscript and reviewed the article. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kyong-Hwa Jun.

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Conflict of Interest

No competing financial interests exist for Ji-Hyun Kim, Hyung-Min Chin, You-Jin Bae, and Kyong-Hwa Jun.

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Kim, JH., Bae, YJ., Jun, KH. et al. Long-Term Trends in Hematological and Nutritional Status After Gastrectomy for Gastric Cancer. J Gastrointest Surg 21, 1212–1219 (2017). https://doi.org/10.1007/s11605-017-3445-7

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  • DOI: https://doi.org/10.1007/s11605-017-3445-7

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