Aoyama Toru, Kawabe Taiichi, Hirohito Fujikawa, Hayashi Tsutomu, Yamada Takanobu, Tsuchida Kazuhito, Sato Tsutomu, Oshima Takashi, Rino Yasushi, Masuda Munetaka, Ogata Takashi, Cho Haruhiko, Yoshikawa Takaki
Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Japan.
Department of Surgery, Yokohama City University, Yokohama, Japan.
Gastric Cancer. 2016 Apr;19(2):645-650. doi: 10.1007/s10120-015-0496-x. Epub 2015 Apr 17.
A significant body weight loss (BWL) is observed during 1 month after gastrectomy for gastric cancer. However, it remains unclear which body component mainly accounts for the weight loss.
Two-hundred forty-four patients who underwent gastrectomy for gastric cancer between May 2010 and October 2013 were examined. Body weight and composition were evaluated by a bioelectrical impedance analyzer within 1 week before surgery (first measurement), at 1 week after surgery (second measurement), and at 1 month after surgery (third measurement). The changes in the early period were defined as the differences until the second measurement, and those in the late period were defined as the differences from the second to the third measurement.
Total BWL within 1 month was -3.4 kg, and the rate of body weight at 1 month to the preoperative body weight was 94.1 %. BWL was significantly greater in the early period than in the late period (-2.1 kg vs -1.2 kg, p < 0.001). In the early period, loss of lean body mass was significantly greater than loss of fat mass (-1.5 kg vs -0.6 kg, p < 0.001). The same trend was observed when the subset of patients who had surgical morbidities was excluded.
BWL during the first week after surgery was significantly greater than that during the subsequent 3 weeks. Furthermore, loss of lean body mass accounted for a significant part of the BWL during the first week.
胃癌胃切除术后1个月内可观察到显著的体重减轻（BWL）。然而，目前尚不清楚是哪种身体成分主要导致了体重减轻。
对2010年5月至2013年10月期间接受胃癌胃切除术的244例患者进行了检查。在手术前1周（首次测量）、手术后1周（第二次测量）和手术后1个月（第三次测量），使用生物电阻抗分析仪评估体重和身体成分。早期变化定义为直至第二次测量的差值，晚期变化定义为从第二次测量到第三次测量的差值。
1个月内的总BWL为-3.4kg，1个月时的体重与术前体重之比为94.1%。早期的BWL显著大于晚期（-2.1kg对-1.2kg，p<0.001）。在早期，瘦体重的减少显著大于脂肪量的减少（-1.5kg对-0.6kg，p<0.001）。排除有手术并发症的患者亚组时，观察到相同趋势。
术后第一周的BWL显著大于随后3周。此外，瘦体重的减少在第一周的BWL中占很大一部分。
