Kawahara Hidejiro, Hiramoto Yuki, Takeda Mitsumasa, Matsumoto Nori, Misawa Takeyuki, Yanaga Katsuhiko
Department of Surgery, Kashiwa Hospital, Jikei University School of Medicine, Chiba, Japan
Department of Surgery, Kashiwa Hospital, Jikei University School of Medicine, Chiba, Japan.
In Vivo. 2019 Jan-Feb;33(1):239-243. doi: 10.21873/invivo.11466.
Postoperative changes in patient anthropometric and nutritional statuses after proctocolectomy due to ulcerative colitis (UC) are unclear.
Between January 2015 and December 2017, nine patients who underwent proctocolectomy with temporary ileostomy (PTI) for UC at our hospital were enrolled in this study. For the comparison group, eight patients who underwent low anterior resection (LAR) with temporary ileostomy for rectal cancer in the same period were recruited. Data, including body weight; body mass index (BMI); levels of total protein, albumin, cholinesterase, and hemoglobin; and lymphocyte counts, were analyzed. The changes in these parameters before surgery until 6 months after surgery were compared.
Before surgery, the levels of total protein, albumin, cholinesterase, hemoglobin and lymphocyte counts in the PTI group were significantly worse than those in the LAR group. However, significant differences were not identified in these factors at 1 month after surgery. The BMI was significantly lower in the PTI group than in the LAR group until 3 months after surgery. An increase in body weight to greater than that prior to surgery was found from 4 months after surgery in the PTI group. The LAR group did not have any effect of surgery in terms of any factor.
BMI appears to be the most useful predictor of clinical and nutritional changes postoperatively.
溃疡性结肠炎(UC)患者行直肠结肠切除术后人体测量学和营养状况的术后变化尚不清楚。
2015年1月至2017年12月,我院9例行直肠结肠切除术并临时回肠造口术(PTI)治疗UC的患者纳入本研究。对照组招募了同期8例行低位前切除术(LAR)并临时回肠造口术治疗直肠癌的患者。分析体重、体重指数(BMI)、总蛋白、白蛋白、胆碱酯酶和血红蛋白水平以及淋巴细胞计数等数据。比较术前至术后6个月这些参数的变化。
术前,PTI组的总蛋白、白蛋白、胆碱酯酶、血红蛋白和淋巴细胞计数水平显著低于LAR组。然而,术后1个月这些因素未发现显著差异。术后3个月内,PTI组的BMI显著低于LAR组。PTI组术后4个月体重开始增加,超过术前水平。LAR组在任何因素方面均未出现手术影响。
BMI似乎是术后临床和营养变化最有用的预测指标。