Katsube Takao, Konnno Soichi, Murayama Minoru, Kuhara Kotaro, Sagawa Masano, Yoshimatsu Kazuhiko, Shiozawa Shunnichi, Shimakawa Takeshi, Naritaka Yoshihiko, Ogawa Kenji
Department of Surgery, Tokyo Women's Medical University, Medical Center East, 2-1-10 Nisiogu Arakawa-ku, Tokyo, 116-8567, Japan.
Hepatogastroenterology. 2008 Sep-Oct;55(86-87):1864-7.
BACKGROUND/AIMS: In Japan, distal gastrectomy is the most common operation performed to treat gastric cancer. However, this procedure often leads to postoperative problems such as weight loss.
We assessed the changes of nutritional status early after operation and the associations of the postoperative body weight (as a percentage of the preoperative weight) and background factors in patients who underwent distal gastrectomy. We measured the changes of nutritional indices (mean body weight, TSF, AMC and Alb) and nutrition intake on the day before operation (before operation), before postoperative resumption of oral intake (before oral intake), and on the fifth day of a soft rice porridge diet (after soft rice). Background factors included gender, age, preoperative BMI and preoperative exercise.
Mean body weight, TSF, and AMC significantly decreased from before operation, to the day before oral intake and to the day after soft rice. The postoperative body weight was not associated with the gender, age, or preoperative BMI. The frequency of regular preoperative exercise was associated with the postoperative body weight. The total daily calorie intake was 1,664 kcal (before operation), 398 kcal (before oral intake), and 949 kcal (after soft rice).
To conclude, nutritional status changes significantly after distal gastrectomy. Early nutrition intervention may be needed in patients who undergo distal gastrectomy for gastric cancer.
背景/目的：在日本，远端胃切除术是治疗胃癌最常用的手术方式。然而，该手术常导致如体重减轻等术后问题。
我们评估了接受远端胃切除术患者术后早期营养状况的变化，以及术后体重（占术前体重的百分比）与背景因素之间的关联。我们测量了营养指标（平均体重、三头肌皮褶厚度、上臂中部周长和白蛋白）的变化，以及术前一天（术前）、术后恢复经口进食前（经口进食前）和软米粥饮食第五天（软米饭后）的营养摄入量。背景因素包括性别、年龄、术前体重指数和术前运动情况。
平均体重、三头肌皮褶厚度和上臂中部周长从术前到经口进食前一天以及软米饭后一天均显著下降。术后体重与性别、年龄或术前体重指数无关。术前规律运动的频率与术后体重有关。每日总热量摄入分别为1664千卡（术前）、398千卡（经口进食前）和949千卡（软米饭后）。
总之，远端胃切除术后营养状况显著改变。对于因胃癌接受远端胃切除术的患者，可能需要早期营养干预。
