Preservation of physiological passage through the remnant stomach prevents postoperative malnutrition after proximal gastrectomy with double tract reconstruction

• DOI: 10.1007/s00595-019-01799-5
• Publication Date: 2019-03-30T10:02:31Z
• Authors: Kohei Yamashita; Masaaki Iwatsuki; Yuki Koga; Tasuku Toihata; Yuki Kiyozumi; Daisuke Kuroda; Kojiro Eto; Yukiharu Hiyoshi; Shiro Iwagami; Yoshifumi Baba; Yuji Miyamoto; Naoya Yoshida; Hideo Baba
• Keywords: Adult; Aged, 80 and over; Male; 2. Zero hunger; Malnutrition; Middle Aged; Plastic Surgery Procedures; 03 medical and health sciences; Postoperative Complications; Sex Factors; 0302 clinical medicine; Gastrectomy; Gastric Stump; Humans; Female; Organ Sparing Treatments; Aged; Retrospective Studies

Double tract reconstruction (DT) after proximal gastrectomy (PG) is considered beneficial for postoperative nutrition status by preserving the physiological passage of food. We conducted this study to assess postoperative nutrition status based on food passage after this operation.The subjects of this retrospective study were 63 patients who underwent PG with DT. The patients were divided into two groups according to whether they had postoperative malnutrition (PM) 1 year postoperatively (PM group) or not (non-PM group). PM was defined by both weight loss > 10% and a low body mass index of < 20 or < 22 kg/m2 for patients younger and older than 70 years, respectively. We then evaluated the predictors of PM.There were 33 patients in the PM group. These patients were predominantly female (p < 0.01) and lacked physiological passage through the remnant stomach (PRS) on postoperative fluoroscopy (defined as non-PRS, p = 0.03). Multivariate logistic regression analysis revealed that female gender and non-PRS status were independent predictors of PM (odds ratio [95% CI]; 7.42 [1.33-41.4]; p = 0.02, 6.77 [1.01-45.4]; p = 0.04, respectively).Preservation of the physiological passage of food through the remnant stomach prevents PM after PG with DT.