Luu Carrie, Arrington Amanda K, Falor Annie, Kim Jae, Lee Byrne, Nelson Rebecca, Singh Gagandeep, Kim Joseph
Division of Surgical Oncology, City of Hope Comprehensive Cancer Center, Duarte, California, USA.
Am Surg. 2014 Oct;80(10):1022-5.
Major gastric resection alters digestive function and may lead to profound weight loss. The objective of our study was to evaluate trends in body weight loss after curative gastrectomy for malignancy. A review of patients who underwent gastrectomy from 1999 to 2012 at two institutions was conducted. Patient demographics and treatment were assessed. Student's t test and analysis of variance were used to compare groups. Of 168 patients, two patients (1.2%) were Stage 0, 73 (43.5%) Stage I, 46 (27.4%) Stage II, 45 (26.8%) Stage III, and two (1.2%) stage unknown. Fifty-eight patients (34.5%) underwent total gastrectomy with Roux-en-Y esophagojejunostomy and 110 patients (65.5%) underwent subtotal gastrectomy. The average per cent decreases in body mass index (BMI) postgastrectomy at one month, six months, 12 months, and 24 months were 7.6, 11.7, 11.5, and 11.1 per cent, respectively (P = 0.003). The decreases in BMI were the same for all time periods whether patients had subtotal or total gastrectomy. Weight loss after gastric cancer resection is an important measure of quality of life. By understanding patterns of weight change after gastrectomy, we can better counsel and prepare our patients for the long-term effects of gastric cancer surgery.
胃大部切除术会改变消化功能，并可能导致体重显著下降。我们研究的目的是评估恶性肿瘤根治性胃切除术后体重下降的趋势。对1999年至2012年在两家机构接受胃切除术的患者进行了回顾性研究。评估了患者的人口统计学特征和治疗情况。采用学生t检验和方差分析对各组进行比较。168例患者中，2例（1.2%）为0期，73例（43.5%）为I期，46例（27.4%）为II期，45例（26.8%）为III期，2例（1.2%）分期不明。58例（34.5%）患者接受了全胃切除加Roux-en-Y食管空肠吻合术，110例（65.5%）患者接受了胃大部切除术。胃切除术后1个月、6个月、12个月和24个月时体重指数（BMI）的平均下降百分比分别为7.6%、11.7%、11.5%和11.1%（P = 0.003）。无论患者接受的是胃大部切除术还是全胃切除术，所有时间段内BMI的下降情况均相同。胃癌切除术后的体重减轻是生活质量的一项重要指标。通过了解胃切除术后体重变化的模式，我们可以更好地为患者提供咨询，并让他们为胃癌手术的长期影响做好准备。
