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Comparison of Postoperative Nutritional Status after Distal Gastrectomy for Gastric Cancer Using Three Reconstructive Methods: a Multicenter Study of over 1300 Patients

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Purpose

Perioperative nutritional status has been reported to be associated with short- and long-term outcomes after surgery in gastric cancer patients. This study compared changes in nutritional status after distal gastrectomy using the Billroth I (BI), Billroth II (BII), and Roux-en-Y (RY) reconstruction techniques in gastric cancer patients.

Materials and Methods

Data from 1305 gastric cancer patients who underwent distal gastrectomy at two tertiary hospitals from January 2011 to December 2016 were reviewed. The patients were divided into three groups according to reconstruction type: BI, BII, and RY. We evaluated changes in nutritional parameters including body mass index (BMI), biochemical data, the prognostic nutritional index (PNI), nutritional risk index (NRI), and geriatric nutritional risk index (GNRI) preoperatively, and 3, 6, and 12 months after surgery.

Results

Total protein, albumin, PNI, and NRI were significantly lower in the BII group than in the BI and RY groups during follow-up (P < 0.001). In multivariate analysis, reconstruction types were independently related to decreases in BMI (> 10%), low serum protein, albumin, and cholesterol 12 months after surgery. Compared with BI, BII was associated with decreased BMI, low protein, and albumin and RY was associated with decreased BMI and low cholesterol.

Conclusion

During the first year after gastric cancer surgery, postoperative nutritional status differed according to the reconstruction type; BI resulted in the least weight and nutritional loss, RY yielded results comparable with BI in the nutritional indexes, and BII resulted in the greatest nutritional loss.

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Authors and Affiliations

  1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea

    You Na Kim, Ji Yeong An, Min-Gew Choi, Jun Ho Lee, Tae Sung Sohn, Jae Moon Bae & Sung Kim

  2. Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea

    You Na Kim

  3. Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea

    Yoon Young Choi & Sung Hoon Noh

Authors
  1. You Na Kim
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  2. Yoon Young Choi
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  3. Ji Yeong An
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  4. Min-Gew Choi
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  5. Jun Ho Lee
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  6. Tae Sung Sohn
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  7. Jae Moon Bae
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  8. Sung Hoon Noh
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  9. Sung Kim
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Contributions

You Na Kim and Ji Yeong An designed and conducted this research. You Na Kim and Yoon Young Choi analyzed data. You Na Kim wrote the paper. Ji Yeong An had primary responsibility for final content. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ji Yeong An.

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The authors declare that they have no conflict of interest.

Ethical Standards

This article does not contain any studies with human or animal subjects performed by any of the authors. This study protocol was approved by the institutional review board of Samsung Medical Center, and Yonsei University College of Medicine, Seoul, Korea (SMC 2018-06-097-002, 4-2018-0495).

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Kim, Y.N., Choi, Y.Y., An, J.Y. et al. Comparison of Postoperative Nutritional Status after Distal Gastrectomy for Gastric Cancer Using Three Reconstructive Methods: a Multicenter Study of over 1300 Patients. J Gastrointest Surg 24, 1482–1488 (2020). https://doi.org/10.1007/s11605-019-04301-1

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  • DOI: https://doi.org/10.1007/s11605-019-04301-1

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