Effects of double-tract reconstruction versus total gastrectomy on nutritional status in patients with gastric cancer / 第二军医大学学报

ABSTRACT

Objective: To explore the influence of different reconstruction methods of digestive tract on postoperative short-term nutritional status of patients with early malignant tumor in upper gastric body. Methods: Retrospective analysis was conducted on 109 patients with early upper gastric cancer who underwent surgical treatment in our hospital from Jun. 2016 to Jan. 2018. Double-tract reconstruction was performed in 59 patients (double-tract reconstruction group), and total gastrectomy was performed in 50 patients (total gastrectomy group). Nutritional indexes (hemoglobin, total protein, albumin and prealbumin) were compared between the two groups during hospitalization (at admission, 1, 3, 5 days after operation, and at discharge) and one year after operation. The changes in body weight were observed in the first year after operation. Results: There were no significant differences in age, gender, body weight or nutritional indexes (hemoglobin, albumin, total protein, prealbumin) at admission, operation time, operation method, tumor location, tumor maximum diameter, or tumor differentiation between the two groups (P>0.05). On the 3rd day after the operation, albumin in the total gastrectomy group was significantly lower than that in the double-tract reconstruction group (t=2.30, P=0.023). There were no significant differences in the hemoglobin, total protein or prealbumin between the two groups on day 1, 3 and 5 after operation, and at discharge (P>0.05). The levels of hemoglobin, total protein, albumin and prealbumin were significantly decreased in both groups at discharge as compared with that at admission (P0.05). But the body weight loss in the double-tract reconstruction group was significantly lower than that in the total gastrectomy group (- 10.45%[- 17.11%, - 5.19%) vs - 17.83%[- 22.06%, - 13.10%], Z=4.31, P<0.01). Conclusion: In comparison to total gastrectomy, double-tract reconstruction surgery can effectively improve the nutritional status of patients with early upper gastric cancer.