The investigation of diet recovery after distal gastrectomy

Abstract

This study aims to investigate the adaptation process of the alimentary tract after distal gastrectomy and understand the impact of remnant stomach volume (RSV) on diet recovery.One year after gastrectomy, although patients’ oral intake had increased, the RSV was decreased and small bowel motility was enhanced. Patients with a larger RSV showed no additional benefits regarding nutritional outcomes.We prospectively enrolled patients who underwent distal gastrectomy with Billroth II reconstruction to treat gastric cancer at a tertiary hospital cancer center between September 2009 and February 2012. Demographic data, diet questionnaires, computed tomography (CT), and contrast fluoroscopy findings were collected. Patients were divided into 2 groups according to the RSV calculated using CT gastric volume measurements (large vs small). Dietary habits and nutritional status were compared between the groups.Seventy-eight patients were enrolled. Diet volume recovered to 90% of baseline by the 36th postoperative month, and RSV was 70% of baseline at 6 months after surgery and gradually decreased over time. One year after surgery, small bowel transit time was 75% compared to the 1st postoperative month (P < .05); however, transit time in the esophagus and remnant stomach showed no change in any studied interval. Compared to patients with a small RSV, those with a large RSV showed no differences in diet volume, habits, or other nutritional benefits (P > .05).Diet recovery for distal gastrectomy patients was achieved by increased small bowel motility. The size of the remnant stomach showed no positive impact on nutritional outcomes.

A comparison of quality of life between patients with small and large gastric remnant volumes after gastrectomy for gastric cancer

“…In a previous study, we reported that compared to those with a large GRV, the patients with a small GRV showed no differences in diet habits, volumes, and other nutritional benefits. [9] The average size of the stomach was approximately 600 cc when inflated with gas in a previous study. We measured the average difference between small and large GRVs to be approximately 100 cc, but an average meal of 100 cc is unlikely to affect the patient significantly.…”

“…The primary treatment of small gastric remnant syndrome is dietary modification. In a previous study, we reported that compared to those with a large GRV, the patients with a small GRV showed no differences in diet habits, volumes, and other nutritional benefits [9] . The average size of the stomach was approximately 600 cc when inflated with gas in a previous study.…”

“…In a previous study, we found that there was no significant difference in diet amount and nutritional status between patients with small and large gastric remnant volumes (GRVs). [9] However, the impact of GRV size on patients' quality of life (QOL) has not yet been clarified. The aim of the present study http://dx.doi.org/10.1097/MD.0000000000026954…”

Effects of individualized dietary counseling on nutritional status and quality of life in post-discharge patients after surgery for gastric cancer: A randomized clinical trial

“…So far, treatment modalities include surgery, chemotherapy, and radiotherapy, and surgery remains the main and most effective therapy for GC (2). However, GC surgery has caused reduction of food storage volume and various gastrointestinal symptoms, threatening the nutritional status of patients to varying degrees (3)(4)(5). Body weight loss and malnutrition are frequently observed in patients who undergo gastrectomy (6).…”

Safety of performing distal pancreatosplenectomy in patients who underwent distal gastrectomy previously: a multicenter cohort analysis with systematic literature review

“…Distal subtotal gastrectomy (STG) is a mainstay of treatment for middle and distal-third gastric cancer [ 1 ]. Distal pancreatectomy (DP) with or without splenectomy is currently the gold standard surgical approach for benign and malignant tumors located in the body and tail of the pancreas [ 2 ].…”