Literature DB >> 15297082

Prospective evaluation of nutritional status related to body mass indices and outcomes after modified D2 gastrectomy for carcinoma.

Paula M Murphy1, Guy R J C Blackshaw, Holly J Paris, Paul Edwards, Jonathan D Barry, Wyn G Lewis.   

Abstract

AIMS: The aim of this study was to examine the perioperative nutritional status, body mass indices (BMI) and nutritional intakes of patients undergoing a modified D2 gastrectomy (preserving pancreas and spleen) for carcinoma to determine whether a relationship exists between the above and outcomes.
METHODS: Fifty consecutive patients [median age 71 years, 38 male] with gastric adenocarcinoma were studied prospectively.
RESULTS: Seven patients (14%) were obese (BMI > 30 kg/m2), 16 patients (32%) were overweight (BMI > 25 kg/m2), 21 patients (42%) were of normal weight (BMI 20-25 kg/m2), and six patients (12%) were underweight (BMI < 20 kg/m2). Operative morbidity was commoner in underweight patients (33%) when compared with overweight patients (17%, P = 0.391) and patients of normal weight (14%, P = 0.289). Fatal complications, however (two patients, 4%) were confined to overweight patients (P = 0.118). Preoperative serum albumin levels were significantly higher in overweight patients (43 g/dl) compared to underweight patients (34.5 g/dl; P = 0.003), though no correlation was found between patients' serum albumin levels and postoperative morbidity (r = -0.023, P = 0.877). Overweight patients were significantly less likely to achieve their protein requirements postoperatively than underweight patients (P = 0.037). Early enteral feeding contributed to 56% of the median energy requirements and 45% of the median protein requirements on the seventh postoperative day.
CONCLUSION: BMI alone is a poor indicator of outcomes after modified D2 gastrectomy for carcinoma. The role of early enteral nutrition in patients undergoing gastrectomy for cancer deserves further evaluation. Copyright 2003 Elsevier Ltd.

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Year:  2004        PMID: 15297082     DOI: 10.1016/j.clnu.2003.07.009

Source DB:  PubMed          Journal:  Clin Nutr        ISSN: 0261-5614            Impact factor:   7.324


  9 in total

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  9 in total

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