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在接受远端胃切除术加胃十二指肠吻合术的胃癌患者中,较大的残胃容积与更好的营养状况和肌肉保留相关。

Larger Remaining Stomach Volume Is Associated With Better Nutrition and Muscle Preservation in Patients With Gastric Cancer Receiving Distal Gastrectomy With Gastroduodenostomy.

作者信息

Kim Amy, Lee Jung-Bok, Ko Yousun, Park Taeyong, Jo Hyeonjong, Jang Jin Kyoo, Lee Kyoungsuk, Kim Kyung Won, Lee In-Seob

机构信息

Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Division of Biostatistics, Center for Medical Research and Information, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

出版信息

J Gastric Cancer. 2022 Apr;22(2):145-155. doi: 10.5230/jgc.2022.22.e15.

Abstract

PURPOSE

Weight loss and deterioration in body composition are observed in patients with gastric cancer (GC) following gastrectomy. This study aimed to investigate the impact of residual stomach volume (RSV) on the nutritional status and body composition of patients with GC treated with distal gastrectomy.

MATERIALS AND METHODS

In total, 227 patients who underwent minimally invasive distal gastrectomy with Billroth 1 anastomosis for stage I GC between February 2015 and May 2018 were enrolled. Clinicodemographic and laboratory data were collected from the GC registry. The RSV, abdominal muscle area, and subcutaneous/visceral fat areas were measured using computed tomography data.

RESULTS

A larger RSV was associated with a lower decrease in the nutritional risk index (P=0.004) and hemoglobin level (P=0.003) during the first 3 months after surgery, and better recovery at 12 months. A larger RSV demonstrated an advantage in the preservation of abdominal muscle area (P=0.02) and visceral fat (P=0.04) after surgery, as well as less reduction in weight (P=0.02) and body mass index (P=0.03).

CONCLUSIONS

Larger RSV was associated with improved nutritional status and better preservation of muscle and fat after distal gastrectomy.

摘要

目的

胃癌(GC)患者胃切除术后会出现体重减轻和身体成分恶化的情况。本研究旨在探讨残胃容积(RSV)对接受远端胃切除术的GC患者营养状况和身体成分的影响。

材料与方法

总共纳入了2015年2月至2018年5月期间接受微创远端胃切除术并采用毕罗一式吻合术治疗I期GC的227例患者。从GC登记处收集临床人口统计学和实验室数据。使用计算机断层扫描数据测量RSV、腹部肌肉面积以及皮下/内脏脂肪面积。

结果

较大的RSV与术后前3个月营养风险指数降低幅度较小(P = 0.004)和血红蛋白水平降低幅度较小(P = 0.003)相关,并且在12个月时恢复得更好。较大的RSV在术后保留腹部肌肉面积(P = 0.02)和内脏脂肪(P = 0.04)方面具有优势,体重(P = 0.02)和体重指数(P = 0.03)下降也较少。

结论

较大的RSV与远端胃切除术后营养状况改善以及肌肉和脂肪更好的保留相关。

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