Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan;
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Anticancer Res. 2022 Jul;42(7):3637-3643. doi: 10.21873/anticanres.15852.
BACKGROUND/AIM: Postoperative body weight loss (BWL) and skeletal muscle loss (SML) after gastrectomy are associated with a decline in quality of life and worse longterm prognosis in gastric cancer (GC) patients. This study aimed to evaluate the efficacy of amino acids nutrition on BWL and SML in the early period following gastrectomy.
The parameters of body composition were measured by bioelectrical impedance analysis in the patients undergoing radical gastrectomy for GC and analyzed retrospectively. Patients received either peripheral parenteral nutrition (PPN) of 4.3% glucose fluid with regular diet (control group, n=43) or PPN of 7.5% glucose fluid containing amino acids plus oral nutritional supplement (ONS) rich in protein with regular diet (amino acids group, n=40) following gastrectomy. The percentages of BWL and SML from preoperative values to those at 7 days and 1 month after surgery were compared between the two groups.
The %BWL and %SML at 7 days after surgery were significantly lower in the amino acids group than those in the control group (%BWL, -2.4±1.7% vs. -4.2±1.8%; p<0.0001, %SML, -4.1±3.8 vs. -6.5±3.8; p=0.006). Moreover, the %BWL at 1 month after surgery was significantly lower in the amino acids group compared to that in the control group (- 4.6±2.9% vs. -6.1±2.6%; p=0.01); however, the %SML was similar between the two groups. The hematological nutritional parameters were similar between the two groups.
Amino acids nutrition by PPN and ONS following gastrectomy prevented postoperative BWL and SML in the early period after surgery in GC patients.
背景/目的：胃癌（GC）患者术后体质量丢失（BWL）和骨骼肌丢失（SML）与生活质量下降和预后不良有关。本研究旨在评估氨基酸营养对胃切除术后早期 BWL 和 SML 的疗效。
通过生物电阻抗分析测量接受 GC 根治性胃切除术患者的身体成分参数，并进行回顾性分析。患者术后接受外周肠外营养（PPN），含 4.3%葡萄糖液加常规饮食（对照组，n=43）或含 7.5%葡萄糖液氨基酸加富含蛋白质的口服营养补充剂（ONS）加常规饮食（氨基酸组，n=40）。比较两组患者从术前到术后 7 天和 1 个月时 BWL 和 SML 的百分比变化。
术后 7 天时，氨基酸组的%BWL 和 %SML 明显低于对照组（%BWL，-2.4±1.7% vs. -4.2±1.8%；p<0.0001，%SML，-4.1±3.8 vs. -6.5±3.8；p=0.006）。此外，术后 1 个月时，氨基酸组的%BWL 明显低于对照组（-4.6±2.9% vs. -6.1±2.6%；p=0.01），但两组间的 %SML 无差异。两组间的血液营养参数相似。
胃切除术后 PPN 和 ONS 给予氨基酸营养可预防 GC 患者术后早期 BWL 和 SML。
