Nutritional Safety of Oncometabolic Surgery for Early Gastric Cancer Patients: a Prospective Single-arm Pilot Study Using a Historical Control Group for Comparison

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2019 Mar 31

PMID 30927123

Citations 6

Authors

Young Suk Park

Do Joong Park

Ki Hyun Kim

Dong Jin Park

Yoontaek Lee

Ki Bum Park

Sa-Hong Min

Sang-Hoon Ahn

Hyung-Ho Kim

Affiliations

Soon will be listed here.

Abstract

Background: Oncometabolic surgery (OS) is a modification of the Roux-en Y reconstruction method, in which the lengths of the biliopancreatic and Roux limbs are longer than that with conventional surgery (CS). Although OS is performed to improve postoperative glycemic control in gastric cancer patients with type 2 diabetes mellitus (T2DM), its postoperative nutritional safety has not been clarified. This prospective pilot study evaluated the safety and feasibility of OS in early gastric cancer patients.

Methods: This study evaluated 20 patients with clinical T1N0 stage and preoperative body mass index (BMI) ≥ 32.5 kg/m, or ≥ 27.5 kg/m with comorbidities, who underwent OS. Primary outcomes were cumulative incidences of anemia and deficiencies in iron and vitamin B12 after 1 year. The outcomes were compared to those of a matched historical control group.

Results: The cumulative incidences of anemia (15.0% vs. 10.0%, P = 0.99), iron deficiency (15.0% vs. 10.0%, P = 0.99), and vitamin B12 deficiency (10.0% vs. 0%, P = 0.47) did not differ significantly in the OS and CS groups. However, median vitamin B12 concentration tended to be lower (395.8 vs. 493.7 pg/mL, P = 0.06) and reductions in vitamin B12 concentration tended to be greater (174.7 vs. 123.0 pg/mL, P = 0.07) in the OS group. BMI loss was similar in the two groups (2.9 vs. 2.8 kg/m, P = 0.80). Remission rates of hypertension (68.8% vs. 41.2%, P = 0.22) and T2DM (77.8% vs. 50.0%, P = 0.58) were higher in the OS group.

Conclusion: Nutritional parameters did not differ significantly in the OS and CS groups. Vitamin B12 levels should be carefully monitored after OS.

Citing Articles

The Metabolic Effects and Effectiveness of the Different Reconstruction Methods used in Gastric Cancer Surgery: A Systematic Review and Meta-Analysis.

Pinho Costa M, Santos-Sousa H, Oliveira C, Amorim-Cruz F, Bouca R, Barbosa E Sci Rep. 2024; 14(1):23477.

PMID: 39379429 PMC: 11461857. DOI: 10.1038/s41598-024-72456-2.

Factors associated with hypertension remission after gastrectomy for gastric cancer patients.

Kang B, Liu X, Cheng Y, Tao W, Peng D World J Gastrointest Surg. 2022; 14(8):743-753.

PMID: 36157372 PMC: 9453326. DOI: 10.4240/wjgs.v14.i8.743.

Current Status and Trends of Minimally Invasive Gastrectomy in Korea.

Park S, Kim J, Park S Medicina (Kaunas). 2021; 57(11).

PMID: 34833413 PMC: 8621245. DOI: 10.3390/medicina57111195.

Effect of oncometabolic surgery on gastric cancer: The remission of hypertension, type 2 diabetes mellitus, and beyond.

Cheng Y, Peng D, Tao W, Zhang W World J Gastrointest Oncol. 2021; 13(9):1157-1163.

PMID: 34616520 PMC: 8465439. DOI: 10.4251/wjgo.v13.i9.1157.

Beneficial effects of proximal intestinal bypass reconstruction on glucose metabolism in a type 2 diabetes animal model: a possible reconstruction strategy for diabetic gastric cancer patients.

Ahn S, Hyung W Ann Surg Treat Res. 2021; 100(4):218-227.

PMID: 33854991 PMC: 8019988. DOI: 10.4174/astr.2021.100.4.218.

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