Changes in the Abdominal Fat Distribution After Gastrectomy: Computed Tomography Assessment

Yoon, Dae Young; Kim, Hyeon Kyu; Kim, Ju Ae; Choi, Choongik; Yun, Eun Joo; Chang, Suk Ki; Lee, Yujin; Park, Chan Heun

doi:10.1111/j.1445-2197.2006.03990.x

Cited by 23 publications

(18 citation statements)

References 19 publications

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“…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). Previous CT image analyses reported decreases in subcutaneous adipose tissue and visceral adipose tissue of approximately 20-40 % and 50-60 %, respectively [25,26]. These findings suggest that the mass of visceral adipose tissue decreases more than that of subcutaneous plus intramuscular adipose tissue after TG.…”

Section: Discussionsupporting

confidence: 55%

“…These findings suggest that the mass of visceral adipose tissue decreases more than that of subcutaneous plus intramuscular adipose tissue after TG. It has been speculated that the decrease in visceral adipose tissue is caused predominantly by the withdrawal of hypothetical gastric hormonal factors, which could increase fat mobilization or inhibit fat deposition within the visceral cavity [25]. Twenty-six patients (25.5 %) showed a significant loss of skeletal muscle of more than 10 % at 1 year after TG.…”

Section: Discussionmentioning

confidence: 99%

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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: 55%

Section: Discussionmentioning

confidence: 99%

Skeletal muscle loss after total gastrectomy, exacerbated by adjuvant chemotherapy

et al. 2014

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“…Siervo et al[27] also reported that body composition varies with BMI, age and sex. Although a significant reduction in body fat has been reported after gastrectomy, several studies indicated that the reduction in skeletal muscle mass was smaller than reductions in the volume of body fat[28-31]. These previous findings may, in part, explain the smaller body weight loss in patients with low BMI (< 18.5), in which, the proportion of the skeletal muscle supposed to be larger than those of the other relevant preoperative BMI groups.…”

Section: Discussionmentioning

confidence: 99%

Predictive factors for body weight loss and its impact on quality of life following gastrectomy

Tanabe

Takahashi

Urushihara

et al. 2017

WJG

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AIMTo determine the predictive factors and impact of body weight loss on postgastrectomy quality of life (QOL).METHODSWe applied the newly developed integrated questionnaire postgastrectomy syndrome assessment scale-45, which consists of 45 items including those from the Short Form-8 and Gastrointestinal Symptom Rating Scale instruments, in addition to 22 newly selected items. Between July 2009 and December 2010, completed questionnaires were received from 2520 patients with curative resection at 1 year or more after having undergone one of six types of gastrectomy for Stage I gastric cancer at one of 52 participating institutions. Of those, we analyzed 1777 eligible questionnaires from patients who underwent total gastrectomy with Roux-en-Y procedure (TGRY) or distal gastrectomy with Billroth-I (DGBI) or Roux-en-Y (DGRY) procedures.RESULTSA total of 393, 475 and 909 patients underwent TGRY, DGRY, and DGBI, respectively. The mean age of patients was 62.1 ± 9.2 years. The mean time interval between surgery and retrieval of the questionnaires was 37.0 ± 26.8 mo. On multiple regression analysis, higher preoperative body mass index, total gastrectomy, and female sex, in that order, were independent predictors of greater body weight loss after gastrectomy. There was a significant difference in the degree of weight loss (P < 0.001) among groups stratified according to preoperative body mass index (< 18.5, 18.5-25 and > 25 kg/m2). Multiple linear regression analysis identified lower postoperative body mass index, rather than greater body weight loss postoperatively, as a certain factor for worse QOL (P < 0.0001) after gastrectomy, but the influence of both such factors on QOL was relatively small (R2, 0.028-0.080).CONCLUSIONWhile it is certainly important to maintain adequate body weight after gastrectomy, the impact of body weight loss on QOL is unexpectedly small.

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“…Yoon et al . [17] reported a greater loss of visceral fat tissue after TG than after subtotal gastrectomy at 6 months after surgery. At 12 months after surgery, the losses in BMI, total adipose tissue, subcutaneous, and visceral fat tissues were all greater after TG than after subtotal gastrectomy.…”

Section: Discussionmentioning

confidence: 99%

Visceral fat changes after distal gastrectomy according to type of reconstruction procedure for gastric cancer

et al. 2013

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BackgroundNoncancerous causes of death, such as cerebrovascular or cardiac disease, are not rare in patients with gastric cancer who had undergone curative gastrectomy. Metabolic syndrome, characterized by visceral fat accumulation, is a risk factor for cerebrovascular and cardiac diseases. However, there is limited information on the effects of reconstruction procedures on changes in visceral fat after distal gastrectomy. The aim of this study was to analyze the impact of the reconstruction procedure (Roux-en-Y reconstruction (RY) and Billroth I reconstruction (BI)) on changes in visceral fat, as determined using computed tomography.MethodsThe study subjects were 152 patients with gastric cancer who underwent distal gastrectomy with lymphadenectomy between 2002 and 2007. The visceral fat area was measured for one cross-sectional computed tomogram obtained at the level of the umbilicus.ResultsAdjuvant chemotherapy (yes vs. no, P = 0.0006), type of reconstruction (BI vs. RY, P = 0.0146), field of lymph node dissection (

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Changes in the Abdominal Fat Distribution After Gastrectomy: Computed Tomography Assessment

Abstract: Patients who underwent gastrectomy lost TAT, VAT and SAT during the postoperative period up to 6 months and the decrease in VAT was greater and more persistent than the decrease in SAT, particularly in the TG group.

Cited by 23 publications

References 19 publications

Skeletal muscle loss after total gastrectomy, exacerbated by adjuvant chemotherapy

Skeletal muscle loss after total gastrectomy, exacerbated by adjuvant chemotherapy

Predictive factors for body weight loss and its impact on quality of life following gastrectomy

Visceral fat changes after distal gastrectomy according to type of reconstruction procedure for gastric cancer

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