Changes in Body Composition after Gastrectomy: Results of a Controlled, Prospective Clinical Trial

Liedman, Bengt; Andersson, Henrik; Bosæus, Ingvar; Hugosson, Irene; Lundell, Lars

doi:10.1007/pl00012264

Cited by 87 publications

(77 citation statements)

References 19 publications

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“…The general extent to which skeletal muscle mass decreases after gastrectomy remains unclear because few body composition studies have been conducted, and no research before our own has used CT image analysis to evaluate changes in skeletal muscle mass following gastrectomy. In this study, the postoperative changes in body composition after TG consisted mainly of the depletion of fat, as seen in previous studies [13][14][15]24]. In fat tissue, a reduction of 56.1 ± 36.4 % in subcutaneous plus intramuscular adipose tissue and a reduction of 77.4 ± 39.0 % in visceral adipose tissue were observed in this study (data not shown).…”

Section: Discussionsupporting

confidence: 87%

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Skeletal muscle loss after total gastrectomy, exacerbated by adjuvant chemotherapy

et al. 2014

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Background Skeletal muscle loss is associated with physical disability, nosocomial infections, postoperative complications, and decreased survival. Preventing the loss of skeletal muscle mass after gastrectomy may lead to improved outcomes. The aims of this study were to assess changes in skeletal muscle mass after total gastrectomy (TG) and to clarify the clinical factors affecting significant loss of skeletal muscle after TG. Patients and methods One hundred and two patients undergoing TG for primary gastric cancer underwent abdominal computed tomography before and 1 year after TG to precisely quantify postoperative changes in skeletal muscle and adipose tissue. Univariate and multivariate logistic regression analyses identified clinical factors contributing to significant loss of skeletal muscle after TG.Results At 1 year after TG, the mass of both skeletal muscle and adipose tissue was reduced by 6.20 ± 6.80 and 65.8 ± 36.1 % of the preoperative values, respectively, and 26 patients (25.5 %) showed a significant loss of skeletal muscle of more than 10 %. Adjuvant chemotherapy with S-1 for C6 months (hazard ratio 26.61, 95 % confidence interval, 3.487-203.1) was identified as the single independent risk factor for a significant loss of skeletal muscle. Conclusions Skeletal muscle loss was exacerbated by extended adjuvant chemotherapy after TG. Further research should identify appropriate nutritional interventions for maintaining skeletal muscle mass and leading to improved outcomes.

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Section: Discussionsupporting

confidence: 87%

“…Although the main postoperative change in body composition after TG is a loss of fat mass, various degrees of skeletal muscle mass reduction have been demonstrated [13][14][15]. Preventing the loss of skeletal muscle mass after TG may lead to improved outcomes.…”

Section: Introductionmentioning

confidence: 99%

Skeletal muscle loss after total gastrectomy, exacerbated by adjuvant chemotherapy

et al. 2014

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“…It has been reported that weight loss usually occurs early, especially within the first 6 months after surgery, although data on changes in body composition after subtotal gastrectomy are limited (Liedman et al, 1997). Our study showed that body weight, body mass index, waist circumference and body fat percentage were decreased 1 year after subtotal gastrectomy, whereas fat-free mass did not change (Table 2).…”

Section: Jeon Et Al 2004supporting

confidence: 44%

“…The reduction of body fat results in weight loss and reduced body mass index after subtotal gastrectomy. In a study about changes in body composition after gastrectomy, it has been reported that approximately 90% of weight loss is caused by reduced body fat (Liedman et al, 1997). However, the reason why the decrease in body fat is most sensitive among compartments of body composition after gastrectomy is unknown.…”

Section: Jeon Et Al 2004mentioning

confidence: 99%

Long-term changes in gut hormones, appetite and food intake 1 year after subtotal gastrectomy with normal body weight

et al. 2010

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Background/Objectives: No prospective study on the long-term effects of gastric resection on gastrointestinal hormonal changes in patients with normal body weight has been reported. The aim of this study was to evaluate the 1-year effect of subtotal gastrectomy on ghrelin and peptide YY (PYY) 3À36 levels. Subjects/Methods: Eighteen patients with early gastric cancer underwent subtotal gastrectomy with Billroth I reconstruction. We assessed appetite, food intake, body composition, and ghrelin and PYY 3-36 levels preoperatively and 1 year after surgery. Results: There were no significant difference in the preoperative daily food intake and 1 year after subtotal gastrectomy. Weight loss occurred in all study subjects; 11.7% (n ¼ 2), 55.5% (n ¼ 10) and 33.3% (n ¼ 6) of the patients lost o5%, 5-10% and 410% of their preoperative body weight, respectively. Body mass index, waist circumference and body fat significantly decreased 1 year after subtotal gastrectomy. There were no significant differences in the appetite visual analogue scale preoperatively and 1 year after subtotal gastrectomy. The plasma ghrelin concentration decreased significantly (P ¼ 0.006), whereas PYY 3À36 did not show a significant change 1 year after subtotal gastrectomy. Conclusions: Ghrelin levels and body fat decreased significantly, whereas PYY 3À36 levels as well as appetite and food intake did not change significantly 1 year after subtotal gastrectomy with normal body weight. These findings suggest that decreased ghrelin might contribute directly to reduced body fat.

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“…One of the advantages of laparoscopic gastrectomy was reported to be the prevention of overt weight loss, which had generally been explained in terms of decrease in protein mass rather than fat mass [7]. Another study has demonstrated selective loss of fat mass during the first 6 months after open gastrectomy, with a minor decrease of arm circumference [8]. There have been no other longitudinal studies evaluating changes in the composition of the body and extremities after gastrectomy.…”

Section: Introductionmentioning

confidence: 99%

Nutritional recovery after open and laparoscopic gastrectomies

et al. 2011

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

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Changes in Body Composition after Gastrectomy: Results of a Controlled, Prospective Clinical Trial

Cited by 87 publications

References 19 publications

Skeletal muscle loss after total gastrectomy, exacerbated by adjuvant chemotherapy

Skeletal muscle loss after total gastrectomy, exacerbated by adjuvant chemotherapy

Long-term changes in gut hormones, appetite and food intake 1 year after subtotal gastrectomy with normal body weight

Nutritional recovery after open and laparoscopic gastrectomies

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