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Nutritional consequences of total gastrectomy.

E L Bradley, J Isaacs, T Hersh

    Annals of Surgery
    |October 1, 1975
    PubMed
    Summary

    Patients undergoing total gastrectomy can maintain nutritional status, with inadequate intake, not severe malabsorption, being the primary cause of postoperative malnutrition. Therapeutic strategies should focus on improving food consumption post-surgery.

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    Area of Science:

    • Surgical Oncology
    • Gastroenterology
    • Nutritional Science

    Background:

    • Total gastrectomy, the surgical removal of the entire stomach, can lead to significant nutritional challenges.
    • Postoperative malnutrition is a concern for patients following this procedure, impacting recovery and long-term health.

    Purpose of the Study:

    • To investigate the nutritional status and metabolic balance in patients after total gastrectomy.
    • To identify the primary mechanisms contributing to malnutrition in this patient population.

    Main Methods:

    • Assessment of nutrient intake, absorption, and utilization in 10 post-total gastrectomy patients.
    • Metabolic balance studies were conducted in a controlled hospital setting and during home environment follow-up.
    • Evaluation of jejunal bacterial overgrowth and the impact of a jejunal pouch construction.

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    Main Results:

    • Patients ingested adequate food for ideal body weight maintenance in a hospital setting, with mild fat and nitrogen malabsorption.
    • Nutrient intake significantly decreased upon returning to the home environment, becoming the primary cause of malnutrition.
    • Jejunal anaerobic bacterial overgrowth was consistently observed in patients with severe malabsorption.

    Conclusions:

    • Postoperative malnutrition after total gastrectomy is often due to inadequate food intake rather than severe malabsorption.
    • Jejunal bacterial overgrowth presents a therapeutic target for managing malabsorption.
    • Total gastrectomy can be safely performed without undue fear of progressive malnutrition.