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KMID : 1034120140060020059
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Journal of Clinical Nutrition
2014 Volume.6 No. 2 p.59 ~ p.70
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A Prospective Observational Study Evaluating the Change of Nutritional Status and the Incidence of Dumping Syndrome after Gastrectomy
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Na Ju-Ri
Suh Yuhn-Suk
Kong Seong-Ho
Lim Jeong-Hyun
Ju Dal-Lae
Yang Han-Kwang
Lee Hyuk-Joon
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Abstract
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Purpose: The aim of this study was to investigate the change of nutritional status and the incidence of dumping syndrome after gastrectomy for gastric cancer.
Methods: From January 2013 to May 2014, 36 patients who underwent gastrectomy for gastric cancer were prospectively investigated in terms of nutritional status by body weight, anthropometric measurements, biochemical data, and Patient-Generated Subjective Global Assessment (PG-SGA). Dumping syndrome was assessed using a newly developed questionnaire based on the Japanese Society of Gastroenterological Surgery survey and Sigstad’s scoring system.
Results: Body weight losses were 4.6%, 8.1%, and 6.9% at discharge, six months, and one year after discharge, respectively. Triceps skinfold thickness had no significance, however, mid-arm muscle circumference showed significant loss after gastrectomy. A part of the biochemical data showed significant change after gastrectomy, but almost indicated a restoring tendency within two months after discharge. In terms of PG-SGA, 33 patients (91.7%) were classified as A (well-nourished) before surgery, however, the number of well-nourished patients showed a sharp decrease to 1 (2.8%) at two weeks after discharge, and then gradually increased to 25 (69.4%) at one year. The main obstacles against diet intake were reported as ‘early satiety’ and ‘anxiety’. The number of patients who had experience in at least one dumping syndrome related symptom was 21 (58.3%) at discharge, 26 (72.2%) at two months after discharge, and 11 (30.6%) at one year after discharge.
Conclusion: Nutritional deficit as well as dumping syndrome is encountered in a large number of gastric cancer patients after gastrectomy. Postoperative nutritional support and personalized education seem to be very important during the postoperative period.
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KEYWORD
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Gastrectomy, Nutritional status, Body weight, Patient-Generated Subjective Global Assessment, Dumping syndrome
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