Metabolic changes of bone have been recognized as one of postgastrectomy sequlae. However, there have until now been no reliable methods to provide an accurate assessment of bone mass status, resulting in a wide variation of the reported
incidence
of
postoperative metabolic bone disorders. Recently an improvement in measuring bone mineral status was achieved using dual energy x-ray absorptiometry(DEXA).
In order to evaluate bone mineral density after various kinds of gastrectomy procedures, fourty five male patients who underwent the surgery for the stomach and colorectal cancer were studied. Group I was consisted of 13 patients who underwent
total
gastrectomy, group II consisted of 16 patients with subtotal gastrectomy with gastroduodenostomy reconstruction (Billroth I), group III, of 9 patients with subtotal gastrectomy with gastrojejunostomy recontruction, and control group, of 7
patients
with
colorectal resection. Measurement of lumbar spine bone mineral density in patients who had gastrectomy(0.84±0.14 in group III) was significantly lower than that of patients who underwent colectomy(control gorup 1.03±0.18g/cm2 in group I,
0.88±0.16 in
group II, and 0.82±0.14 in group III) was significantly lower than that of patients who underwent colectomy(control group 0.03±0.18 g/㎠). Serum hemoglobulin(12±1.19gm/dl) and total calcium(4.75±0.21mEp/L) levels i patient with gastrectomy
were
significantly lower than those of colectomy group(14.1±0.85 and 4.75±0.10, respectively).
This study demonstrates that in postoperative bone mineral density and serum total calcium level there are no differences among patients with various gastrectomy types, however, lower values than in patents with colectomy. (Korean J Gastroenterol
1994 ;
26 : 800-805)
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