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World Journal of Surgery

, Volume 22, Issue 3, pp 254–261 | Cite as

Nutritional Status of Gastric Cancer Patients after Total Gastrectomy

  • Jae-Moon Bae
  • Jong-Wan Park
  • Han-Kwang Yang
  • Jin-Pok Kim

Abstract. 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 immmunochemotherapy 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.

Keywords

Gastric Cancer Patient Total Gastrectomy Daily Calorie Intake Jejunal Biopsy Poor Oral Intake 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Société Internationale de Chirugie 1998

Authors and Affiliations

  • Jae-Moon Bae
    • 1
  • Jong-Wan Park
    • 2
  • Han-Kwang Yang
    • 3
  • Jin-Pok Kim
    • 3
  1. 1.Department of Surgery, College of Medicine, Ewha Women’s University Mokdong Hospital, 911-1 Mok-dong, Yangcheon-ku, Seoul 158-056, KoreaKP
  2. 2.Department of Pharmacology, College of Medicine, Seoul National University, Yonkon-dong 28, Chongno-ku, Seoul 110-799, KoreaKP
  3. 3.Department of Surgery, College of Medicine, Seoul National University, Yonkon-dong 28, Chongno-ku, Seoul 110-799, KoreaKP

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