Iron deficiency anemia after subtotal gastrectomy for gastric cancer

Sideropenic anemia after a gastrectomy is a frequent complication. The aim of the present study was to evaluate the role of different factors, such as sex, age, atrophic chronic gastritis, Helicobacter pylori infection and iron malabsorption, in iron deficiency after surgery for gastric cancer.

Thirty-seven patients who underwent subtotal gastrectomy for carcinoma of the stomach were prospectively studied following a specific three-year protocol. Iron deficiency was evaluated by hemochromocytometric analysis and serum iron-ferritin level assays.

Of the different variables analyzed, atrophic chronic gastritis was associated with a lower mean serum iron level, in particular two years after surgery (65mg/dL vs. 103 mg/dL in subjects without gastritis, P<0.01); a correlation between Helicobacter pylori infection of the gastric stump and lower mean serum ferritin level was also found (25+/-6.3 mg/dL vs. 53+/-0.4 mg/dL, P<0.05). On the contrary, no association was observed with the other factors that were evaluated.

Among the factors involved in iron deficiency after gastrectomy for cancer of the stomach, atrophic gastritis seems to be the most important, although Helicobacter pylori infection of the gastric stump also seems to play an important role.