Nutritional Assessment in patients Following Total Gastrectomy

Masashi Terashima

First Department of Surgery, Chiba University, School of Medicine

To study the longterm effect of total gastrectomy, nutritional parameters were studied in 16 patients 5.9±2.2 years after total gastrectomy for gastric carcinoma. A group of patients who underwent partial gastrectomy 6.1±2.1 years ago served as a control group. Nutritional intake was assessd by taking dietary histories. The nutritional parameters included anthropometric parameters, serum trace elements (Fe, Zn, Cu, Mn, Cr) and serum vitamin concentrations (vitamin A, B₁, B₂, B₁₂, 25-OH-D₃, E, nicotinic acid, biotin, panthothenic acid, folic acid) Results: Energy intake in the totally gastrectomized patients was significantly greater than that of the control, being 38.6±4.7 kcal/kg (170±44% of calculated basic metabolic rate). The anthropometric parameters of total gastrectomy group however, were low than those of the control group, suggesting that the patients were potentially in marasmus type malnutrition. The concentrations of all the fat soluble vitamins were decreased, B₁₂ and folic acid were also decreased, while biotin increased. Serum zinc decreased, and Mn and Cr showed higher concentrations. These results indicate that the diets taken by the patients after total gastrectomy are near the recommended daily allowanoes, but still, the patients are potentially deficient in all the fat soluble vitamins and some of the water soluble vitamins, and thus warrant daily supplements of vitamins and digestive enzyme preparations, on this patient population.

Key words
nutritional assessment in patients following total gastrectomy, quality of life after total gastrectomy, nutritional and metabolic parameters after gastrectomy, calorie intake, vitamins and trace minerals

Reprint requests
Masashi Terashima First Department of Surgery, Chiba University, School of Medicine
1-8-1 Inohana, Chuo-ku, Chiba, 260 JAPAN

Accepted
February 9, 1994

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