Department of Digestive Surgery, University of Yamanashi Hospital, 1110 Shimokato, Yamanashi, Chuo, 409-3898, Japan.
World J Surg Oncol. 2024 Oct 8;22(1):267. doi: 10.1186/s12957-024-03549-5.
Despite recent reports, the effectiveness of postoperative oral nutritional supplementation (ONS) on body weight loss and malnutrition after gastrectomy remains controversial. We aimed to elucidate the effectiveness of ONS especially in octogenarian patients undergoing oncological gastrectomy.
A total of 286 consecutive patients who underwent gastrectomy for gastric cancer were eligible. Postoperative body weight loss, malnutrition, and sarcopenia were compared between patients with and without postoperative ONS among octogenarian patients aged ≥ 80 years and non-octogenarian patients aged < 80 years.
In this study, 36 (62.1%) octogenarian and 121 (53.1%) non-octogenarian patients continued postoperative ONS for three months. The clinicopathologic characteristics were not different between the ONS (-) and ONS (+) groups among the octogenarian and non-octogenarian patients. The changes in body weight and serum albumin levels at postoperative 1 year were different between the ONS (-) and ONS (+) groups (P = 0.03 and P = 0.04, respectively) among the octogenarian patients, but not between the two groups among the non-octogenarian patients (P = 0.99 and P = 0.29, respectively). Also, the decline in psoas muscle mass index at postoperative 6 months and 1 year was significantly lower in the ONS (+) group than in the ONS (-) group (P < 0.01 and P < 0.01, respectively). In addition, similar results were found in octogenarian patients who underwent distal gastrectomy.
Postoperative ONS could prevent body weight loss, malnutrition, and sarcopenia especially in octogenarian patients who underwent gastrectomy for gastric cancer.
尽管最近有报道称，术后口服营养补充（ONS）对胃癌术后体重减轻和营养不良的有效性仍存在争议。我们旨在阐明 ONS 的有效性，特别是在接受肿瘤性胃切除术的 80 岁以上患者中。
共有 286 例连续接受胃癌胃切除术的患者符合条件。比较了 80 岁以上和<80 岁的患者中，术后 ONS 组和非 ONS 组的术后体重减轻、营养不良和肌肉减少症。
本研究中，36 例（62.1%）80 岁以上患者和 121 例（53.1%）<80 岁患者继续接受术后 ONS 治疗 3 个月。80 岁以上和<80 岁患者中，ONS（-）和 ONS（+）组的临床病理特征无差异。80 岁以上患者术后 1 年体重和血清白蛋白水平的变化在 ONS（-）和 ONS（+）组之间存在差异（P=0.03 和 P=0.04），但在<80 岁患者中，两组之间无差异（P=0.99 和 P=0.29）。此外，ONS（+）组术后 6 个月和 1 年时的竖脊肌质量指数下降明显低于 ONS（-）组（P<0.01 和 P<0.01）。此外，远端胃切除术的 80 岁以上患者也得到了类似的结果。
术后 ONS 可预防体重减轻、营养不良和肌肉减少症，特别是在接受胃癌胃切除术的 80 岁以上患者中。
