Hematologic Complications of Partial Gastrectomy

Mahmud, Khalid; Ripley, Donna; Swaim, William R.; Doscherholmen, Alfred

doi:10.1097/00000658-197304000-00009

Cited by 21 publications

(6 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hines et al and Khalid et al reported cobalamin deficiency in only 10 - 20% of patients 8 years after partial gastrectomy. Up to 6% of these cobalamin-deficient patients developed manifestations of cobalamin deficiency with megaloblastic anemia 20,21. In our study, 4 cases who were treated by total gastrectomy and 6 cases treated by subtotal gastrectomy were followed up for longer than 5 years (maximal 9.6 years follow up for total gastrectomy, 7.5 years for subtotal gastrectomy).…”

Section: Discussionmentioning

confidence: 71%

Therapeutic Comparison of Chemotherapy and Surgery for Early Stage Diffuse Large B-cell Gastric Lymphoma

2007

View full text Add to dashboard Cite

PurposeThe use of surgery versus stomach-preserving treatment for primary gastric lymphoma has caused controversy among doctors. This retrospective, single center study aims to evaluate the efficacy and benefit of stomach-preserving treatment against surgery for early stage diffuse large B-cell lymphoma of stomach.Materials and MethodsFrom August 1991 to January 2006, 43 cases of early-stage diffuse large B-cell gastric lymphoma were reviewed.ResultsEleven cases were treated with chemotherapy or chemotherapy plus radiation (CT ± RT), 17 were treated with surgery alone (OP), and 15 were treated with surgery plus adjuvant chemotherapy (OP + CT). The complete remission and response rates were 63.6% and 90.9% in those treated with CT ± RT (7 complete responders, 3 partial responders, 1 non-responder), 100% and 100% in those treated with OP, and 100% and 100% in those treated with OP + CT, respectively. Five-year overall survival rates were 85.7%, 87.5%, and 100% in those treated by CT ± RT, OP, and OP + CT, respectively (p = 0.76). The five-year disease free survival rates were 100%, 87.5% and 100% in those treated by CT ± RT, OP, and OP + CT, respectively (p = 0.99). There was no significant difference in overall survival and disease free survival between modalities. Even though there are no definite differences in the number of complications between those treated by CT ± RT or OP, these facts reflect little concern on complications after surgery.ConclusionIn preventing morbidity arising from early or late complications from surgery and promoting quality of life, chemotherapy should be a primary consideration for early stage diffuse large B-cell lymphoma of the stomach.

show abstract

Section: Discussionmentioning

confidence: 71%

Therapeutic Comparison of Chemotherapy and Surgery for Early Stage Diffuse Large B-cell Gastric Lymphoma

2007

View full text Add to dashboard Cite

show abstract

“…Although the incidence of vitamin B12 deficiency at 48 mo after gastrectomy was high in our study, only one patient with vitamin B12 deficiency presented with megaloblastic anemia. Because 70% of patients with vitamin B12 deficiency at 48 mo after gastrectomy showed anemia and the majority of these were irondeficient, the generation of macrocytosis by concomitant iron deficiency should be considered [26] . Vitamin B12 deficiency can develop within 2 years after total gastrectomy and vitamin B12 replacement may be considered for postgastrectomy patients with persistent anemia despite iron replacement or with neurological symptoms combined with vitamin B12 deficiency.…”

Section: A B D Cmentioning

confidence: 99%

Anemia after gastrectomy for early gastric cancer: Long-term follow-up observational study

Lim

Kim²,

Kim³

et al. 2012

WJG

View full text Add to dashboard Cite

AIM:To identify the incidence and etiology of anemia after gastrectomy in patients with long-term follow-up after gastrectomy for early gastric cancer. METHODS:The medical records of those patients with early gastric adenocarcinoma who underwent curative gastrectomy between January 2006 and October 2007 were reviewed. Patients with anemia in the preoperative workup, cancer recurrence, undergoing systemic chemotherapy, with other medical conditions that can cause anemia, or treated during follow up with red cell transfusions or supplements for anemia were excluded. Anemia was defined by World Health Organization criteria (Hb < 12 g/dL in women and < 13 g/dL in men). Iron deficiency was defined as serum ferritin < 20 μg/dL. Vitamin B12 deficiency was defined as serum vitamin B12 < 200 pg/mL. Iron deficiency anemia was defined as anemia with concomitant iron deficiency. Anemia from vitamin B12 deficiency was defined as megaloblastic anemia (mean cell volume > 100 fL) with vitamin B12 deficiency. The profile of anemia over 48 mo of follow-up was analyzed. RESULTS:One hundred sixty-one patients with gastrectomy for early gastric cancer were analyzed. The incidence of anemia was 24.5% at 3 mo after surgery and increased up to 37.1% at 48 mo after surgery. The incidence of iron deficiency anemia increased during the follow up and became the major cause of anemia at 48 mo after surgery. Anemia of chronic disease and megaloblastic anemia were uncommon. The incidence of anemia in female patients was significantly higher than in male patients at 12 (40.0% vs 22.0%, P = 0.033), 24 (45.0% vs 25.0%, P = 0.023), 36 (55.0% vs 28.0%, P = 0.004), and 48 mo (52.0% vs 31.0%, P = 0.022) after surgery. Patients with total gastrectomy showed significantly higher incidence of anemia than patients with subtotal gastrectomy at 48 mo after surgery (60.7% vs 31.3%, P = 0.008). The incidence of iron deficiency was significantly higher in female patients than in male patients at 6 (35.4% vs 13.3%, P = 0.002), 12 (45.8% vs 16.8%, P < 0.001), 18 (52.1% vs 22.3%, P < 0.001), 24 (60.4% vs 20.9%, P < 0.001), 36 (62.5% vs 29.2%, P < 0.001), and 48 mo (66.7% vs 34.7%, P = 0.001) after surgery. CONCLUSION:Anemia was frequent after gastrectomy for early gastric cancer, with iron deficiency being the major cause. Evaluation for anemia including iron status should be performed after gastrectomy and appropriate iron replacement should be considered.

show abstract

“…Intrinsic factor also mediates the absorption in the terminal ileum. Reduced cobalamin assimilation has been observed in patients with chronic gastric hyposecretion, such as during chronic atrophic gastritis [93,94,95,96], long-term therapy with PPIs [90] and after vagotomy [92, 97]. Especially subsets of Helicobacter-pylori -infected persons have an increased risk to develop cobalamin deficiency.…”

Section: Gastric Acid and Digestive And Mucosal Processesmentioning

confidence: 99%

Do We Need Gastric Acid?

et al. 2008

View full text Add to dashboard Cite

Evidence from comparative anatomy and physiology studies indicates that gastric acid secretion developed during the evolution of vertebrates approximately 350 million years ago. The cellular mechanisms that produce gastric acid have been conserved over the millennia and therefore proton pump inhibitors have pharmacological effects in almost all relevant species. These observations suggest that gastric acid provides an important selective advantage; however, in modern-day humans the need for gastric acid can be questioned in light of the widespread use of safe and effective pharmacologic acid suppression. The Kandahar Working Group addressed questions concerning the need, production and effects of gastric acid, specifically: (1) motility in the upper gastrointestinal (GI) tract; (2) neuroendocrine factors; (3) digestive and mucosal processes; (4) microbiology, and (5) central processes and psychological involvement. We addressed each topic with the individual models available to answer our questions including animal versus human studies, pharmacologic, surgical as well as pathophysiologic states of acid suppression.

show abstract

Hematologic Complications of Partial Gastrectomy

Cited by 21 publications

References 17 publications

Therapeutic Comparison of Chemotherapy and Surgery for Early Stage Diffuse Large B-cell Gastric Lymphoma

Therapeutic Comparison of Chemotherapy and Surgery for Early Stage Diffuse Large B-cell Gastric Lymphoma

Anemia after gastrectomy for early gastric cancer: Long-term follow-up observational study

Do We Need Gastric Acid?

Contact Info

Product

Resources

About