Impact of gastrectomy on body composition within 1 month in patients with gastric cancer

Surg Today. 2023 Jul;53(7):834-844. doi: 10.1007/s00595-022-02633-1. Epub 2022 Dec 14.

Abstract

Purpose: The present study examined the changes in and risk factors for body composition (BC) during the first postoperative month when dynamic biological reactions occur.

Methods: We retrospectively assessed 202 patients who underwent gastrectomy. The BC was assessed using a bioelectrical impedance analysis and evaluated within 1 month preoperatively, 1 week postoperatively, and 1 month postoperatively. Multiple regression analyses were performed to identify predictive factors for BC change.

Results: The mean reduction rate in BC at 1 month postoperatively was - 6.0, - 10.5, - 5.6, - 1.1, - 10.1, and + 1.2% for body weight, body fat, skeletal muscle, bone mineral, extracellular water/total body water, and the whole-body phase angle, respectively. A multiple regression analysis revealed that independent risk factors for weight loss were complications, operative time, and type of gastrectomy (P = 0.004, 0.011, 0.015, respectively), and those for skeletal muscle loss were complications and gastrectomy type (P = 0.002, 0.010, respectively). A segmental lean mass analysis revealed that the lower limbs were markedly reduced at 1 week postoperatively (- 8.0%), and these independent risk factors were the female sex and Stage II/III disease (P = 0.008, 0.036, respectively).

Conclusion: Detailed analyses of BC might help elucidate the mechanisms underlying postoperative physical changes, which might be useful for perioperative management.

Keywords: Body composition; Gastrectomy; Stomach neoplasms.

MeSH terms

  • Body Composition / physiology
  • Body Weight / physiology
  • Female
  • Gastrectomy / adverse effects
  • Humans
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Stomach Neoplasms* / etiology
  • Stomach Neoplasms* / surgery