Aoyama Toru, Yoshikawa Takaki, Maezawa Yukio, Segami Kenki, Kano Kazuki, Numata Masakatsu, Yamada Takanobu, Tamagawa Hiroshi, Fujikawa Hirohito, Komori Keisuke, Hayashi Tsutomu, Sato Tsutomu, Yukawa Norio, Rino Yasushi, Masuda Munetaka, Ogata Takashi, Cho Haruhiko, Oshima Takashi
Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Kanagawa, Japan
Department of Surgery, Yokohama City University, Yokohama, Japan.
Anticancer Res. 2019 Feb;39(2):1073-1078. doi: 10.21873/anticanres.13215.
Body weight, especially lean body mass, significantly decreases after gastrectomy. Postoperative surgical complications are a major risk factor for changes in body weight and body composition after gastrectomy. However, the influence of postoperative surgical complications after gastrectomy on body weight and body composition changes remains unclear.
This retrospective study examined patients who underwent curative surgery for gastric cancer between May 2010 and February 2017. Their body weight and composition were evaluated by a bioelectrical impedance analyzer within 1 week before surgery, and at 1 week, 1 month and 3 months after surgery. Patients were classified as those with surgical complications and those without.
Eight hundred and eighty-eight patients (156 in the group with complications and 732 in the group without) were entered in the present study. When comparing the two groups, the patients' background and surgical factors significantly differed, while the pathological findings were similar. The body weight losses at 1 week, 1 month, and 3 months after surgery were 3.8%, 7.0%, and 10.4%, respectively, in those with complications, and 3.3%, 5.6%, and 6.8%, respectively, in the group without, with p-values of 0.001, 0.002, and 0.001, respectively. The corresponding lean body mass losses were 3.7%, 6.5%, and 6.8%, and 3.2%, 4.2%, and 3.5%, respectively, with p-values of 0.001, 0.001, and 0.001, respectively.
Decreases in body weight and lean body mass after gastrectomy were more serious in the patients with surgical complications than in those without. To maintain body weight and lean body mass in patients with surgical complications, additional care or treatments are needed.
胃切除术后体重，尤其是瘦体重显著下降。术后手术并发症是胃切除术后体重和身体成分变化的主要危险因素。然而，胃切除术后手术并发症对体重和身体成分变化的影响仍不清楚。
这项回顾性研究检查了2010年5月至2017年2月期间接受胃癌根治性手术的患者。在手术前1周内以及手术后1周、1个月和3个月，通过生物电阻抗分析仪评估他们的体重和身体成分。患者分为有手术并发症组和无手术并发症组。
本研究纳入了888例患者（并发症组156例，无并发症组732例）。比较两组时，患者的背景和手术因素有显著差异，而病理结果相似。有并发症患者术后1周、1个月和3个月的体重减轻分别为3.8%、7.0%和10.4%，无并发症组分别为3.3%、5.6%和6.8%，p值分别为0.001、0.002和0.001。相应的瘦体重损失分别为3.7%、6.5%和6.8%以及3.2%、4.2%和3.5%，p值分别为0.001、0.001和0.001。
胃切除术后有手术并发症的患者体重和瘦体重下降比无并发症的患者更严重。为维持有手术并发症患者的体重和瘦体重，需要额外的护理或治疗。
