Postgastrectomy Syndromes and Nutritional Considerations Following Gastric Surgery

Davis, Jeremy L.; Ripley, R. Taylor

doi:10.1016/j.suc.2016.11.005

Cited by 87 publications

(107 citation statements)

References 96 publications

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“…Previous studies have reported total weight loss of 10e15% in the early postoperative phase [29,30]. In the long term permanent weight loss of 8.3e13.6% has been reported [7,31,32]. We observed that 45% of the patients had a persistent weight loss of >10% at follow up, which is consistent with previous findings, where 67% of subjects had >10% weight loss at two years postoperatively [12].…”

Section: Discussionsupporting

confidence: 92%

“…Several authors have called for a review of the contemporary follow up regimes after gastrectomy, with special attention to nutritional status [20,39]. Weight monitoring and evaluation by a dietician including multidisciplinary preoperative assessment, patient education and management of postoperative symptoms in the short and long term have been suggested [7].…”

Section: Discussionmentioning

confidence: 99%

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Nutritional status, sarcopenia, gastrointestinal symptoms and quality of life after gastrectomy for cancer – A cross-sectional pilot study

Gharagozlian

Mala

Brekke

et al. 2020

Clinical Nutrition ESPEN

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Background and aims: Gastrointestinal (GI) symptoms, malabsorption, reduced food intake and weight loss are common sequela of gastrectomy. This can result in malnutrition with a subsequent prolonged recovery, reduced physical functioning and deteriorated quality of life (QoL). Few studies have investigated the relationship between GI-symptoms, QoL and malnutrition in long-term survivors of gastric cancer. Therefore, we assess nutritional status, GI-symptoms and QoL 2e5 years after gastrectomy for malignancy. Methods: A cross-sectional, pilot study was carried out in patients who underwent total or subtotal gastrectomy at Oslo University Hospital between 2012 and 2016, who had not experienced disease recurrence. Subjects above 85 years were excluded. The nutritional status of the patients fell into three groups by a score of subjective global assessment (SGA)-A, B, and C. Muscle mass was measured by body composition by bioelectrical impedance analysis and muscle strength was measured by handgrip strength (HGS). Dietary intake was assessed by repeated 24-h dietary recalls. GI-symptoms and QoL were assessed using GI-Symptom Rating Scale (GSRS) and the SF-36 questionnaire. Results: 21 patients were included. Mean (SD) weight loss was 12.8% (11.6) from preoperative status to follow up. Percentage weight loss was larger after total gastrectomy compared with subtotal gastrectomy (17.9% (12.3) vs. 6.6% (7.1) (p ¼ 0.03)). A low mean intake of energy and protein was reported compared to dietary recommendations for the general Nordic population and intake in a national dietary survey. All of the patients were classified as pre-sarcopenic, and 5% as sarcopenic. Persistent weight loss >10% was observed in 45% of the subjects and these were in risk of malnutrition. Subjects with malnutrition had higher GSRS score for the abdominal pain syndrome (p ¼ 0.042) and lower SF-36 scores for bodily pain (p ¼ 0.01) and vitality (p ¼ 0.02) compared with those without malnutrition. Conclusions: A high prevalence of weight loss, and pre-sarcopenia was observed. Malnutrition as assessed by SGA was associated with more GI-Symptoms and reduced QoL scores. Further studies with larger number of participants are needed to verify our findings.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Nutritional status, sarcopenia, gastrointestinal symptoms and quality of life after gastrectomy for cancer – A cross-sectional pilot study

Gharagozlian

Mala

Brekke

et al. 2020

Clinical Nutrition ESPEN

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“…Diarrhoea and other digestive tract ailments observed in patients after gastrectomy related with oncological reasons is always a considerable problem [13]. Recovery in these patients is difficult, and their energy expenditure related with maintaining the homeostasis is definitely greater than in the case of healthy people.…”

Section: Discussionmentioning

confidence: 99%

Postoperative supplementation of propionate and silicon dioxide in patients after total gastrectomy – preliminary report

Domagalska¹,

Grzechulski²,

Paszkowski³

et al. 2020

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Introduction: Post-operative impairment of gastrointestinal tract function and metabolic consequences occur in patients after gastrectomy by Roux-en-Y method. Short-chain fatty acids and silicon dioxide may prove beneficial in the treatment of these conditions. Aim: To evaluate a preparation containing propionic acid and silicon dioxide on the body weight, number of stools and their consistency (the Bristol scale), and pain and a feeling of gastric fullness after a meal, in patients after gastrectomy by Roux-en-Y method. Material and methods: Measurements were performed at the beginning of the study, on day 7 and 14 of application (Colostop ® ; Miralex, 2 × 15 g/day). Results and conclusions: Initially the average daily number of movements was 10/day, after the therapy it was 3.8/day. At the beginning of the study, 3 patients described their faeces as type 6 and two as type 7 on the Bristol scale. After supplementation, 3 patients described stool consistency as type 5, and two as type 4. Initially, patients rated their pain at 3.4/10 on average, the stomach fullness as 4.6/10. At the end of the study, 3 patients did not feel any pain, while others reported pain at 1/10. Four patients described their feeling of gastric fullness as 1/10, and 1 no longer observed this feeling. Patients disclaimed any adverse effects, and satisfaction after therapy reached 9-10/10 points. Patients' body weight did not change significantly. An improvement in standard diet tolerance was observed. Despite the limited study group, clinical benefits of the supplementation were observed.

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“…During that period, treatment of the symptoms of post-gastrectomy syndrome (PGS) occurring immediately after surgery is also necessary. Therefore, when administering AC, chemotherapy-related adverse events caused by each regimen and various symptoms of PGS after surgery should be fully noted and treated effectively, regardless of who administered AC [ 14 15 ].…”

Section: Discussionmentioning

confidence: 99%

Who Can Perform Adjuvant Chemotherapy Treatment for Gastric Cancer? A Multicenter Retrospective Overview of the Current Status in Korea

et al. 2018

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PurposeTo investigate the current status of adjuvant chemotherapy (AC) regimens in Korea and the difference in efficacy of AC administered by surgical and medical oncologists in patients with stage II or III gastric cancers.Materials and MethodsWe performed a retrospective observational study among 1,049 patients who underwent curative resection and received AC for stage II and III gastric cancers between February 2012 and December 2013 at 29 tertiary referral university hospitals in Korea. To minimize the influence of potential confounders on selection bias, propensity score matching (PSM) was used based on binary logistic regression analysis. The 3-year disease-free survival (DFS) rates were compared between patients who received AC administered by medical oncologists or surgical oncologists.ResultsBetween February 2012 and December 2013 in Korea, the most commonly prescribed AC by medical oncologists was tegafur/gimeracil/oteracil (S-1, 47.72%), followed by capecitabine with oxaliplatin (XELOX, 16.33%). After performing PSM, surgical oncologists (82.74%) completed AC as planned more often than medical oncologists (75.9%), with statistical significance (P=0.036). No difference in the 3-year DFS rates of stage II (P=0.567) or stage III (P=0.545) gastric cancer was found between the medical and surgical oncologist groups.ConclusionsS-1 monotherapy and XELOX are a main stay of AC, regardless of whether the prescribing physician is a medical or surgical oncologist. The better compliance with AC by surgical oncologists is a valid reason to advocate that surgical oncologists perform the treatment of AC for stage II or III gastric cancers.

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Postgastrectomy Syndromes and Nutritional Considerations Following Gastric Surgery

Cited by 87 publications

References 96 publications

Nutritional status, sarcopenia, gastrointestinal symptoms and quality of life after gastrectomy for cancer – A cross-sectional pilot study

Nutritional status, sarcopenia, gastrointestinal symptoms and quality of life after gastrectomy for cancer – A cross-sectional pilot study

Postoperative supplementation of propionate and silicon dioxide in patients after total gastrectomy – preliminary report

Who Can Perform Adjuvant Chemotherapy Treatment for Gastric Cancer? A Multicenter Retrospective Overview of the Current Status in Korea

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