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위절제술 후 영양 상태의 변화와 덤핑 증후군 발생에 대한 전향적 관찰 연구
나주리 ( Ju Ri Na ),서윤석 ( Yuhn Suk Suh ),공성호 ( Seong Ho Kong ),임정현 ( Jeong Hyun Lim ),주달래 ( Dal Lae Ju ),양한광 ( Han Kwang Yang ),이혁준 ( Hyuk Joon Lee ) 한국정맥경장영양학회 2014 한국정맥경장영양학회지 Vol.6 No.2
Purpose: The aim of this study was to investigate the change of nutritional status and the incidence of dumping syndrome aftergastrectomy for gastric cancer. Methods: From January 2013 to May 2014, 36 patients who underwent gastrectomy for gastric cancer were prospectively investigated in terms of nutritional status by body weight, anthropometric measurements, biochemical data, and Patient-Generated Subjective Global Assessment (PG-SGA). Dumping syndrome was assessed using a newly developed questionnaire based on the Japanese Society of Gastroenterological Surgery survey and Sigstad’s scoring system. Results: Body weight losses were 4.6%, 8.1%, and 6.9% at discharge, six months, and one year after discharge, respectively. Triceps skinfold thickness had no significance, however, mid-arm muscle circumference showed significant loss after gastrectomy. A part of the biochemical data showed significant change after gastrectomy, but almost indicated a restoring tendency within two months after discharge. In terms of PG-SGA, 33 patients (91.7%) were classified as A (well nourished) before surgery, however, the number of well-nourished patients showed a sharp decrease to 1 (2.8%) at two weeks after discharge, and then gradually increased to 25 (69.4%) at one year. The main obstacles against diet intake were reported as ‘early satiety’ and ‘anxiety’. The number of patients who had experience in at least one dumping syndrome related symptom was 21 (58.3%) at discharge, 26 (72.2%) at two months after discharge, and 11 (30.6%) at one year after discharge. Conclusion: Nutritional deficit as well as dumping syndrome is encountered in a large number of gastric cancer patients after gastrectomy. Postoperative nutritional support and personalized education seem to be very important during the postoperative period.
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