Abstract
That severe malnutrition affects body function and psychological well-being is well documented. We addressed the question of whether quality of life relates to changes in variables such as food intake, body composition, and gastrointestinal symptomatology after gastrectomy for gastric cancer. Thirty-two patients undergoing gastric resection had their dietary intake, body composition, and specific and general aspects of quality of life determined preoperatively, at 12 months and, in the 15 surviving patients, several years after the operation. The patients lost 10% of their preoperative weight (mainly body fat) during the first year. Food intake did not correlate to changes in body composition or quality of life. Gastrointestinal symptoms adversely related to changes in lean body mass, meal size, and general aspects of quality of life for a long time after the operation. Gastrointestinal symptom control seems important to minimize impairment in quality of life, body composition, and eating after gastrectomy.
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References
Adams JF: The clinical and metabolic consequences of total gastrectomy. I. Morbidity, weight, and nutrition. Scand J Gastroenterol 2:137–149, 1967
Ambrecht U, Lundell L, Lindstedt G. Stockbrügger RW: Causes of malabsorption after total gastrectomy with Rouxen-Y reconstruction. Acta Chiru Scand 154:37–41, 1988
Bradly EL III, Isaacs J, Hersh T, Davidsson ED, Millikan W: Nutritional consequences of total gastrectomy. Ann Surg 182:415–429, 1975
Olbe L, Lundell L: Intestinal function of total gastrectomy and possible consequences of gastric replacement. World J Surg 11:713–719, 1987
Schwartz A, Büchler M, Usinger K, Rieger H, Glasbrenner B, Friess H, Kunz R, Beger HG: Importance of the duodenal passage and pouch volume after total gastrectomy and reconstruction with the Ulm pouch: Prospective randomized clinical study. World J Surg 20:60–67, 1996
Hays RP: Anatomic and physiologic reconstruction following total gastrectomy by the use of a jejunal pouch. Surg Forum 4:291, 1953
Hunt JC: Construction of a food pouch from a segment of jejunum as substitute for stomach in total gastrectomy. Arch Surg 64:601, 1952
Lygidakis NJ: Long term results of a new method of reconstruction for continuity of the alimentary tract after total gastrectomy. Surg Gynecol Obstet 158:335–338, 1984
Herfarth C, Schlag P, Buhl K: Surgical procedures for gastric substitution. World Surg 11:689–698, 1987
Aaronson NK, Cull A, Kaasa S (for the EORTC Study Group on Quality of Life): In: Quality of Life and Pharmaco-Economics in Clinical Trials, 2nd ed. B. Spilker (ed). Philadelphia, Lippincott-Raven, 1996, pp 179–89
Cleary PD, Greenfield S, McNiel BJ: Assessing quality of life after surgery. Control Clin Trials 12:189, 1991
Kusche J, Westweber KH, Troidl H: Quality of life after total gastrectomy for stomach cancer: Results of three types of quality of life evaluative methods. Scand J Gastroenterol 22:96–101, 1987
Sullivan M: Quality of life assessment in medicine: Concepts, definitions, purpose, and basic tools. Nord J Psychiatry 00:46–79, 1992
Buhl K, Schlag P, Herfart C. Quality of life and functional results following different types of gastric resection for gastric carcinoma. Eur J Surg Oncol 16:404–409, 1990
Svedlund J, Sullivan M, Liedman B, Lundell L, Sjödin I: Quality of life after gastrectomy for gastric carcinoma. A controlled study of reconstructive procedures. World J Surg 21:422–433, 1997
Svedlund J, Sjödin I, Dotevall G: GSRs–a clinical rating scale for gastrointestinal symptoms in patients with irritable bowel syndrome and peptic ulcer disease. Dig Dis Sci33:129–34, 1988
Forsberg C, Cedermark B: Well-being, general health and coping ability: 1–year follow-up of patients treated for colorectal and gastric cancer. Eur J Cancer Care (Engl); 5(4):209–216, 1996
Jentschurra D, Winkler M, Strohmeier N, Rumstadt B, Hagmuller E: Quality of life after curative surgery for gastric cancer: a comparison between total gastrectomy and subtotal gastric resection. Hepato-Gastroenterol 44(16):1137–1142, 1997
Wu CW, Hsieh MC, Lo SS, Lui WY, P'eng FK. Quality of life of patients with gastric adenocarcinoma after curative gastrectomy. World J Surg 21(7):777–782, 1997
Freeman LM, Roubenoff R: The nutrition implications of cardiac cachexia. Nutr Rev 52:340, 1994
Keys A, Brozel J, Cerschel A: The biology of human starvation. Minneapolis, University of Minnesota Press, 1950
Crawford DH, Shepherd RW, Halliday JW, Cooksley GW, Golding SD, Cheng WS, Powell LW: Body composition in non-alcoholic cirrhosis; the effect of disease etiology and severity on nutritional compartments. Gastroenterology 106:1611, 1994
Buhl K, Lehnert T, Schlag P, Herfarth C: Reconstruction after gastrectomy and quality of life. World J Surg 19:558–564, 1995
Svedlund J, Sullivan M, Liedman B, Lundell L: Long-term consequences of gastrectomy for patient' quality of life: the impact of reconstructive techniques. Am J Gastroenterol 94(2):438–445, 1999
Liedman B, Andersson H, Bosaeus I, Hugosson I, Lundell L: Changes in body composition after gastrectomy. Results of a controller, prospective clinical trial. World J Surg 21:416, 1997
Liedman B, Andersson H, Berglund B, Bosaeus I, Hugosson I, Olbe L, Lundell L. Food intake after gastrectomy for gastric carcinoma–the role of gastric reservoir. Br J Surg 83:1138, 1996
Bruce A, Andersson M, Arvidsson B, Isaksson B: Body composition of normal potassium, body water and body fat in adults on the basis of body height, body weight and age. Scand J Clin Invest 40:461, 1980
Gilson BS, Gilson JS, Bergner M, Bobbit RA, Kressel S, Pollard WE, Vesselago M: The sickness impact profile: Development and final revision of a health status measure. Med Care 19:787, 1981
Sjöberg L, Svensson E, Persson LO. The measurement of mood. Scand J Psychol 20:1–18, 1979
Asberg M, Montgomery SA, Perris C, Schalling D, Sedvall G: The CPRS–development and applications of a psychiatric rating scale. Acta Psychiatr Scand (suppl)271:5–27, 1978
Persson LO, Sjöberg L: Mood and somatic symptoms. J Psychosom Res 31:499–511, 1987
Gurland BJ, Yorkston NJ, Stone AR, Frank JD, Fleiss JL: The structured and scaled interview to assess maladjustment (SSIAM). Arch Gen Psychiatry 27:259–264, 1972
Karnofsky DA, Abelmann WH, Craver LF, Burchenal JH: The use of nitrogen mustards in the palliative treatment of carcinoma. Cancer 1:634–656, 1948
Schwartz A, Büchler M, Usinger K, Rieger H, Glasbrenner B, Friess H, Kunz R, Beger HG: Importance of the duodenal passage and pouch volume after total gastrectomy and reconstruction with the Ulm pouch: Prospective randomized clinical study. World J Surg 20:60–67, 1996
Liedman B, Bosaeus I, Hugosson I, Lundell L: Long-term beneficial effects of a gastric reservoir on weight control after total gastrectomy: A study of potential mechanisms. Br J Surg Apr; 85(4):542–527, 1998
Huguir M, Lancret JM, Bernhard PF, Baschet C, Le Henand F: Functional results of different reconstructive procedures after total gastrectomy. Br J Surg 63:704, 1976
Moreno AH: Studies on nutritional and other disturbances following operations for cancer of the stomach. With particular reference to use of a jejunal pouch as a substitute gastric reservoir. Ann Surg 144:799, 1956
Zittel T, Zeeb B, Maer GW, Kaiser GW, Zwimer M, Liebich H, Starlinger M, Becker HD: High prevalence of bone disorders after gastrectomy. Am J Surg 174:431, 1997
Liedman B, Bosaeus I, Mellström D, Lundell L: Osteoporosis after total gastrectomy–results of a prospective, clinical study. Scand J Gastroenterol 32:1090, 1997
Ambrecht U, Lundell L, Stockbrugger R: The benefit of pancreatic enzyme substitution after total gastrectomy. Allient Pharmacol Ther 00:493; 1988
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Liedman, B., Svedlund, J., Sullivan, M. et al. Symptom Control May Improve Food Intake, Body Composition, and Aspects of Quality of Life After Gastrectomy in Cancer Patients. Dig Dis Sci 46, 2673–2680 (2001). https://doi.org/10.1023/A:1012719211349
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DOI: https://doi.org/10.1023/A:1012719211349