Osaki Tomohiro, Matsunaga Tomoyuki, Makinoya Masahiro, Shimizu Shota, Shishido Yuji, Miyatani Kozo, Tsuda Ayumi, Endo Kanenori, Ashida Keigo, Tatebe Shigeru, Fujiwara Yoshiyuki
Department of Surgery, Tottori Prefectural Central Hospital, Tottori, Japan.
Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago, Japan.
J Gastrointest Surg. 2025 Feb;29(2):101931. doi: 10.1016/j.gassur.2024.101931. Epub 2024 Dec 12.
After gastrectomy for gastric cancer, patients often lose significant body weight because of decreased caloric intake and nutrient absorption. Body weight typically requires approximately 1 year to stabilize. This study aimed to examine the changes and predictors of body composition during the first postoperative year.
A total of 230 patients underwent radical gastrectomy for stage I to III gastric cancers. Body composition was measured using bioelectrical impedance analysis, and changes were analyzed over 1 year. Multiple regression analysis was used to identify predictors of body composition changes.
Body composition changes and significant body weight and body fat mass reductions occurred primarily within the first 6 months postoperatively. Skeletal muscle mass initially decreased but improved after 6 months without significant changes related to adjuvant chemotherapy. Increased edema was observed at 6 and 12 months postoperatively in patients after total gastrectomy and adjuvant chemotherapy. Gastrectomy type and body mass index significantly affected postoperative body weight changes. In addition, gastrectomy type was associated with changes in skeletal muscle mass and bone mineral content. Adjuvant chemotherapy significantly affected the whole-body phase angle at 6 and 12 months.
Our findings emphasized the initial significant reductions postoperatively and subsequent adjustments over time and elucidated the complex interplay between surgical techniques, adjuvant treatment, and patient characteristics and midterm changes in body composition.
胃癌患者行胃切除术后,常因热量摄入和营养吸收减少而出现显著体重下降。体重通常需要约1年时间才能稳定。本研究旨在探讨术后第1年身体成分的变化及预测因素。
共有230例I至III期胃癌患者接受了根治性胃切除术。采用生物电阻抗分析测量身体成分,并分析1年内的变化情况。采用多元回归分析确定身体成分变化的预测因素。
身体成分变化以及显著的体重和体脂量减少主要发生在术后的前6个月。骨骼肌量最初减少,但6个月后有所改善,且与辅助化疗无显著相关性。全胃切除术后接受辅助化疗的患者在术后6个月和12个月时出现水肿增加。胃切除类型和体重指数显著影响术后体重变化。此外,胃切除类型与骨骼肌量和骨矿物质含量的变化有关。辅助化疗在术后6个月和12个月时显著影响全身相位角。
我们的研究结果强调了术后初期的显著减少以及随时间的后续调整,并阐明了手术技术、辅助治疗、患者特征与身体成分中期变化之间的复杂相互作用。