Nutritional recovery after open and laparoscopic gastrectomies

The aim of this study was to evaluate longitudinal changes in body composition after laparoscopic and open gastrectomies for gastric cancer.

Body mass, arm muscle mass, leg muscle mass, and fat mass were measured by performing a bioelectrical impedance analysis using a "Bodyscan" body composition analyzer (HXE19-JA; Konami, Tokyo, Japan) in 41 patients who had undergone gastrectomy: 14 patients underwent open distal gastrectomy, 8 patients underwent open total gastrectomy, and 19 patients underwent laparoscopy-assisted distal gastrectomy. All measurements were obtained preoperatively and at 1, 3, and 6 months after the operation.

Fat mass decreased significantly throughout the 6-month period after distal gastrectomy and until 3 months after the laparoscopic surgery, while similar reductions in the total muscle mass and limb muscle mass were observed only in the first month after operation for all three groups. Patients with the laparoscopic approach had completely regained muscle mass at 6 months postoperatively.

Both fat and muscle mass reductions were responsible for the body weight loss during the first postoperative month, whereas loss of fat mass contributed to further weight loss after that period. Enhanced recovery of muscle mass at 6 months after laparoscopic surgery suggests the benefit of this surgery, among other factors.