Staël von Holstein C, Walther B, Ibrahimbegovic E, Akesson B
Department of Surgery, Lund University, Sweden.
Br J Surg. 1991 Sep;78(9):1084-7. doi: 10.1002/bjs.1800780917.
Dietary intake and nutritional status were studied in two groups of patients after total gastrectomy (n = 10) and after partial gastrectomy (n = 10). All patients were reconstructed with a Roux-en-Y loop. Investigations were carried out 4-17 years after the operation. Eight patients in the group undergoing total gastrectomy and four patients undergoing partial gastrectomy had gastric carcinoma and were without recurrent disease 5-15 years after the operation. A clinical dietician conducted an anthropometric evaluation. All patients underwent an upper gastrointestinal endoscopy, clinical examination, [14C]triolein breath test and a blood chemistry profile. The median weight loss from operation to investigation was 2.1 kg in the partial gastrectomy group and 6.7 kg in the total gastrectomy group (n.s.). After partial gastrectomy three patients had a subnormal body mass index (n.s.). This was not found in the total gastrectomy group. Energy intake was below that recommended in seven patients in the partial gastrectomy group (three of them had a subnormal body mass index) and in two in the total gastrectomy group (n.s.) [14C]triolein breath testing revealed fat malabsorption in three patients after partial gastrectomy and in five patients after total gastrectomy (n.s.).
对两组患者进行了饮食摄入和营养状况研究,一组为全胃切除术后患者(n = 10),另一组为胃部分切除术后患者(n = 10)。所有患者均采用 Roux-en-Y 袢进行重建。研究在术后4 - 17年进行。全胃切除组中有8例患者、胃部分切除组中有4例患者患有胃癌,术后5 - 15年无疾病复发。一名临床营养师进行了人体测量评估。所有患者均接受了上消化道内镜检查、临床检查、[14C]三油酸甘油酯呼气试验和血液生化检查。胃部分切除组从手术到检查的体重减轻中位数为2.1 kg,全胃切除组为6.7 kg(无显著差异)。胃部分切除术后,3例患者的体重指数低于正常范围(无显著差异)。全胃切除组未发现这种情况。胃部分切除组中有7例患者的能量摄入低于推荐水平(其中3例体重指数低于正常范围),全胃切除组中有2例患者出现这种情况(无显著差异)。[14C]三油酸甘油酯呼气试验显示,胃部分切除术后有3例患者、全胃切除术后有5例患者存在脂肪吸收不良(无显著差异)。