Nutritional therapy reduces body weight loss after gastrectomy
Oral nutritional supplementation may significantly reduce body weight loss in gastrectomized patients tolerating more than 200 ml of the nutrient per day vs those who cannot tolerate this amount, a study has found.
The study included 82 stage I to III gastric cancer patients who underwent distal or total gastrectomy. A liquid enteral nutritional formula (at a recommended dosage of 400 kcal/400 ml) was administered orally as a supplement to regular meals within 7 days after the surgery. Supplementation lasted 3 months postoperatively.
Ratio of the weight loss at 3 months postoperatively to the preoperative body weight (body weight loss ratio) was assessed as the primary endpoint. Secondary endpoints included adherence to nutritional therapy and changes in body composition.
The average rate of body weight loss at 3 months after the operation was 8.3 percent, and the mean daily intake of the oral nutritional supplement was 211 ml. A significant correlation was observed between adherence to oral nutritional therapy and body weight loss ratio (p<0.001).
On multiple linear regression analysis, adherence to the nutritional therapy emerged as the only factor that correlated with the body weight loss ratio among all clinical characteristics investigated (p=0.007).
Gastric cancer ranks third as the most common cause of cancer death worldwide. Standard gastrectomy, which plays a major role in the treatment of resectable gastric cancer, involves resection of the distal part of more than two-thirds of the whole stomach along with concomitant lymphadenectomy. [Gastric Cancer 2016;doi:10.1007/s10120-016-0622-4; http://globocan.iarc.fr]
However, patients who undergo the said procedure are at risk of developing malnutrition due to the loss of reservoir function in the upper gastrointestinal tract, among other reasons. Previous data show that those who underwent open distal gastrectomy demonstrated body weight loss of 13 percent in the 6 months postoperatively, whereas patients who underwent total gastrectomy lost 17 percent of body weight [Gastric Cancer 2011;14:144–9]
Malnutrition after gastrectomy is considered to be associated with postoperative complications and morbidity, which could affect survival of gastric cancer patients after curative surgery. The present data demonstrate the potential of oral nutritional supplementation in the management of postoperative malnutrition, researchers said. [Clin Nutr Res 2016;5:65–78; Ann Surg Oncol 2013;20:1575–83; World J Gastroenterol 2014;20:8244–52]