Comparison of Post-Operative Nutritional Status according to the Extent of Gastrectomy and the Reconstruction Method in Patients with Gastric Cancer

Abstract

Purpose: Malnutrition is the main complication after gastrectomy and the degree may vary depending on the extent of resection. This study sought to help determine an appropriate type of resection and provide methods for addressing malnutrition after gastrectomy. Materials and Methods: We retrospectively reviewed medical records of patients with gastric cancer who underwent radical resection at the Soonchunhyang University Cheonan Hospital between December 2012 and December 2013. A total of 100 patients were screened, and all patients were followed for 1 to 3 years. Among this group, 12 underwent total gastrectomy, 5 underwent proximal gastrectomy, 46 underwent distal gastrectomy with Billroth I anastomosis, and 37 with Billroth II anastomosis. The nutritional status assessment included body weight, body mass index, serum albumin, serum hemoglobin, vitamin B12, ferritin, and Nutritional Risk Index (NRI). Results: Patients who underwent total gastrectomy had lower hemoglobin and vitamin B12 levels compared to patients who underwent distal gastrectomy. The NRI was statistically significantly lower in patients who underwent total gastrectomy than patients who underwent distal gastrectomy. Patients who underwent total gastrectomy had lower vitamin B12 than patients who underwent proximal gastrectomy till the second year after gastrectomy. Regarding postdistal gastrectomy reconstruction, there was no statistically significant difference between the Billroth I and Billroth II groups. Conclusion: This study showed that patients who underwent total gastrectomy were more susceptible to malnutrition than those who underwent distal or proximal gastrectomy. Patients who undergo gastrectomy should be monitored carefully for nutritional status and given appropriate nutritional support in the post-operative period.