Effect of Oral Intake on Nutritional Status after Gastric Resection

ABSTRACT

PURPOSE: Malnutrition is a common postoperative complication that occurs after gastric resection. Several causes for malnutrition have been proposed, which include malabsorption and poor oral calorie intake. We performed this study to evaluate whether nutritional counseling would increase oral calorie intake and improve nutritional status in patients who had undergone gastrectomy. MATENRIALS AND METHODS: Twenty-two patients were randomly selected as the study group from among patients who had undergone gastrectomy for early gastric cancer and gastric polyp between October 1999 and December 2000. Body weight, hemoglobin, serum albumin, and serum transferrin were checked before and after the gastrectomy. Oral calorie intake was evaluated by using a 3-day oral-intake diary, and one nutritionist performed outpatient-based nutritional counseling. Eighteen patients who had undergone gastrectomy for the same disease during the same period were selected as the control group. RESULTS: During an average interval of 14.8 months, the study patients received nutritional counseling an average of 3.4 times at an average interval of 4.4 months. The study group took a mean of 2055.6+/-418.1 Cal per day and the control group 1792.1+/-421.9 Cal (P=0.05). Sixty-eight percent (15 patients) of the study group patients reached the daily-required calorie intake. Postoperative bodyweights were 64.0+/-9.9 kg for the study group and 64.3+/-10.8 kg for the control group (P>0.05). No statistically significant differences were observed among the other. Sixty-five percent of the patients (26 patients) had a weight loss of less than 10% of the preoperative body weight, and 35% had more than a 10% weight loss, but there was no statistical difference between the calorie intakes of these patients. CONCLUSION: Nutritional counselling increased the oral calorie intake, but nutritional status was not improved. These results suggest that nutritional derangement after gastrectomy cannot be corrected by adequate oral intake itself.