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Journal of Gastrointestinal Surgery

, Volume 22, Issue 7, pp 1137–1143 | Cite as

Risk Factors for Weight Loss 1 Year After Esophagectomy and Gastric Pull-up for Esophageal Cancer

  • Seong Yong Park
  • Dae Joon Kim
  • Jee Won Suh
  • Go Eun Byun
Original Article

Abstract

Background

Loss of body weight is regarded as a marker of malnutrition after esophagectomy. This study investigated changes in body weight and risk factors for weight loss after esophagectomy for esophageal cancer.

Methods

We retrospectively reviewed records of 181 patients who underwent esophagectomy and gastric pull-up from 2012 to June 2016. Patients with operative mortality and recurrences were excluded. Percent change in body weight was defined as change in body weight (%) = (1-year body weight − preoperative body weight) × 100/preoperative body weight.

Results

Mean age of patients was 62.98 ± 8.23 years with 164 men (90.6%). Mean preoperative body weight was 63.12 ± 9.42 kg, and body weight at 1 year was 56.04 ± 8.59 kg. Mean change in body weight was − 10.95 ± 7.50%, and 98 (54.1%) patients showed weight loss more than 10% compared to initial body weight. Univariable analysis showed that initial body weight, narrow gastric tube, thoracotomy, laparotomy, and postoperative vocal cord palsy (VCP) were related to more than 10% weight loss. Multivariable analysis showed that initial body weight (odds ratio [OR] = 1.041, p = 0.031) and postoperative VCP (OR = 2.772, p = 0.025) were adverse risk factors for weight loss 1 year after esophagectomy, whereas conduit type, route of reconstruction, postoperative complications, anastomotic complications, minimally invasive esophagectomy, and adjuvant therapy were not.

Conclusions

Initial body weight and postoperative VCP were related to weight loss. Patients with VCP need additional nutritional monitoring and support.

Keywords

Esophagus Malnutrition Esophagectomy 

Notes

Author Contributions

(I) Conception and design: Seong Yong Park.

(II) Administrative support: Seong Yong Park.

(III) Provision of study materials or patients: All authors.

(IV) Collection and assembly of data: Seong Yong Park, Go Eun Byun, Jee Won Suh.

(V) Data analysis and interpretation: Seong Yong Park, Dae Joon Kim.

(VI) Manuscript writing: Seong Yong Park.

(VII) Final approval of manuscript: All authors.

Compliance with Ethical Standards

Conflict of Interest

No authors have financial disclosures or conflicts of interest.

References

  1. 1.
    D'Journo X, Ouattara M, Loundou A, Trousse D, Dahan L, Nathalie T, Doddoli C, Seitz J, Thomas PA. Prognostic impact of weight loss in 1-year survivors after transthoracic esophagectomy for cancer. Diseases of the Esophagus 2012;25(6):527–534.CrossRefPubMedGoogle Scholar
  2. 2.
    Ouattara M, D'Journo XB, Loundou A, Trousse D, Dahan L, Doddoli C, Seitz JF, Thomas P-A. Body mass index kinetics and risk factors of malnutrition one year after radical oesophagectomy for cancer. European Journal of Cardio-Thoracic Surgery 2012;41(5):1088–1093.CrossRefPubMedGoogle Scholar
  3. 3.
    Martin L, Jia C, Rouvelas I, Lagergren P. Risk factors for malnutrition after oesophageal and cardia cancer surgery. British Journal of Surgery 2008;95(11):1362–1368.CrossRefPubMedGoogle Scholar
  4. 4.
    Martin L, Lagergren J, Lindblad M, Rouvelas I, Lagergren P. Malnutrition after oesophageal cancer surgery in Sweden. British Journal of Surgery 2007;94(12):1496–1500.CrossRefPubMedGoogle Scholar
  5. 5.
    Park SY, Yoon J-K, Lee SJ, Haam S, Jung J. Postoperative change of the psoas muscle area as a predictor of survival in surgically treated esophageal cancer patients. Journal of thoracic disease 2017;9(2):355.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Kitagawa H, Namikawa T, Munekage M, Fujisawa K, Munekage E, Kawanishi Y, Kobayashi M, Hanazaki K. Analysis of factors associated with weight loss after esophagectomy for esophageal cancer. Anticancer research 2016;36(10):5409–5412.CrossRefPubMedGoogle Scholar
  7. 7.
    Rice TW, Blackstone EH, Rusch VW. of the AJCC Cancer Staging Manual: esophagus and esophagogastric junction. Annals of surgical oncology 2010;17(7):1721–1724.CrossRefPubMedGoogle Scholar
  8. 8.
    Okada G, Matsumoto Y, Nakamura Y, Hayashi F, Kato K, Momoki C, Yasui Y, Habu D, Edagawa E, Matsuda Y. Nutritional changes and factors contributing to postoperative weight recovery after esophagectomy. Esophagus 2017:1–8.Google Scholar
  9. 9.
    Martin L, Lagergren P. Long-term weight change after oesophageal cancer surgery. British Journal of Surgery 2009;96(11):1308–1314.CrossRefPubMedGoogle Scholar
  10. 10.
    Yamasaki M, Miyata H, Yasuda T, Shiraishi O, Takahashi T, Motoori M, Yano M, Shiozaki H, Mori M, Doki Y. Impact of the route of reconstruction on post-operative morbidity and malnutrition after esophagectomy: a multicenter cohort study. World journal of surgery 2015;39(2):433–440.CrossRefPubMedGoogle Scholar
  11. 11.
    Van Lanschot J, van Blankenstein M, Oei H, Tilanus H. Randomized comparison of prevertebral and retrosternal gastric tube reconstruction after resection of oesophageal carcinoma. British journal of surgery 1999;86(1):102–108.CrossRefPubMedGoogle Scholar
  12. 12.
    Khiria L, Pal S, Peush S, Chattopadhyay T, Deval M. Impact on outcome of the route of conduit transposition after transhiatal oesophagectomy: a randomized controlled trial. Digestive and Liver Disease 2009;41(10):711–716.CrossRefPubMedGoogle Scholar
  13. 13.
    Bhattacharyya N, Kotz T, Shapiro J. Dysphagia and aspiration with unilateral vocal cord immobility: incidence, characterization, and response to surgical treatment. Annals of Otology, Rhinology & Laryngology 2002;111(8):672–679.CrossRefGoogle Scholar
  14. 14.
    Ollivere B, Duce K, Rowlands G, Harrison P, O'Reilly B. Swallowing dysfunction in patients with unilateral vocal fold paralysis: aetiology and outcomes The Journal of Laryngology & Otology 2006;120(1):38–41.CrossRefGoogle Scholar
  15. 15.
    Jang YY, Lee SJ, Jeon JY, Lee SJ. Analysis of video fluoroscopic swallowing study in patients with vocal cord paralysis. Dysphagia 2012;27(2):185–190.CrossRefPubMedGoogle Scholar
  16. 16.
    Couper G. Jejunostomy after oesophagectomy: a review of evidence and current practice. Proceedings of the Nutrition Society 2011;70(3):316–320.CrossRefPubMedGoogle Scholar
  17. 17.
    Weijs TJ, van Eden HW, Ruurda JP, Luyer MD, Steenhagen E, Nieuwenhuijzen GA, van Hillegersberg R. Routine jejunostomy tube feeding following esophagectomy. Journal of thoracic disease 2017;9(Suppl 8):S851.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© The Society for Surgery of the Alimentary Tract 2018

Authors and Affiliations

  • Seong Yong Park
    • 1
  • Dae Joon Kim
    • 1
  • Jee Won Suh
    • 1
  • Go Eun Byun
    • 1
  1. 1.Department of Thoracic and Cardiovascular SurgeryYonsei University College of MedicineSeoulRepublic of Korea

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