[Protein-energy malnutrition in the gastrectomized patient]

Arq Gastroenterol. 2002 Jan-Mar;39(1):3-10. doi: 10.1590/s0004-28032002000100002.
[Article in Portuguese]

Abstract

Background: Gastrectomy leads to nutritional consequences that although expected, are not usually measured due to methodological limitations.

Aim: To assess the protein-energy deficiency degrees estimated by isolated or combined indicators.

Patients and methods: There were studied 71 patients, who had undergone partial (n = 53) or total (n = 18) gastrectomy in the last 6-24 months (M1) or 24-60 months (M2). The dietary intake, body composition and biochemical data were estimated and compared between groups and moments.

Results: The surgeries were undertaken after complications of peptic ulcer (68%) or due to gastric cancers (32%). Weight loss was referred by 70% of patients and higher (16 +/- 5 x 10 +/- 6 kg) in total gastrectomy group. The patients showed anthropometric deficits along with normal albumin and low energy intake, suggesting chronic-energy deficiency. Hematocrit, hemoglobin and iron showed the most prominent reductions. Anemia was installed earlier and worsened in the total gastrectomy group. Thus, when combining hemoglobin + albumin, + total lymphocyte count + arm circumference and subscapular skinfold, the protein-energy deficiency prevalence was higher and more severe than when hemoglobin was omitted. The protein-energy deficiency occurred earlier and it was more severe in total gastrectomy patients, while in partial gastrectomy the protein-energy deficiency increased in the late post-operative period.

Conclusion: The protein-energy deficiency resulted from gastrectomy is more marasmus-like coarsing with anemia, both installed earlier and severer in total gastrectomy than partial gastrectomy but ending up similarly at the late postoperatory.

Publication types

  • Comparative Study
  • English Abstract

MeSH terms

  • Adult
  • Aged
  • Anthropometry
  • Brazil / epidemiology
  • Female
  • Gastrectomy / adverse effects*
  • Gastrointestinal Neoplasms / surgery
  • Humans
  • Male
  • Middle Aged
  • Nutritional Status
  • Peptic Ulcer / surgery
  • Prevalence
  • Protein-Energy Malnutrition / epidemiology
  • Protein-Energy Malnutrition / etiology*
  • Weight Loss