Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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Long-Term Nutritional Outcomes of Near-Total Gastrectomy in Gastric Cancer Treatment: a Comparison with Total Gastrectomy Using Propensity Score Matching Analysis

  • Seo, Ho Seok (Division of Gastrointestinal Surgery, Department of Surgery, College of Medicine, The Catholic University of Korea) ;
  • Jung, Yoon Ju (Division of Gastrointestinal Surgery, Department of Surgery, College of Medicine, The Catholic University of Korea) ;
  • Kim, Ji Hyun (Division of Gastrointestinal Surgery, Department of Surgery, College of Medicine, The Catholic University of Korea) ;
  • Park, Cho Hyun (Division of Gastrointestinal Surgery, Department of Surgery, College of Medicine, The Catholic University of Korea) ;
  • Kim, In Ho (Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Lee, Han Hong (Division of Gastrointestinal Surgery, Department of Surgery, College of Medicine, The Catholic University of Korea)
  • Received : 2018.06.18
  • Accepted : 2018.06.26
  • Published : 2018.06.30
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Abstract

Purpose: This study sought to examine whether near total gastrectomy (nTG) confers a longterm nutritional benefit when compared with total gastrectomy (TG) for the treatment of gastric cancer. Materials and Methods: Patients who underwent nTG or TG for gastric cancer were included (n=570). Using the 1:2 matched propensity score, 25 patients from the nTG group and 50 patients from the TG group were compared retrospectively for oncologic outcomes, including long-term survival and nutritional status. Results: The length of the proximal resection margin, number of retrieved lymph nodes and tumor nodes, metastasis stage, short-term postoperative outcomes, and long-term survival were not significantly different between the groups. The body mass index values, and serum total protein and hemoglobin levels of the patients decreased significantly until postoperative 6 months, and then recovered slightly over time (P<0.05); however, there was no difference in the levels between the groups. The prognostic nutritional index values and serum albumin levels decreased significantly until postoperative 6 months and then recovered (P<0.05); the levels decreased more in the nTG group than in the TG group (P<0.05). The mean corpuscular volumes and serum transferrin levels increased significantly until postoperative 1 year and then recovered slightly over time (P<0.05); however, there was no difference between the groups. Serum vitamin $B_{12}$, iron, and ferritin levels of the patients did not change significantly over time, and no difference existed between the groups. Conclusions: A small remnant stomach after nTG conferred no significant nutritional benefits over TG.

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References

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