OBJECTIVE

Comparative assessment of the nutritional status (NS) of patients with gastric cancer (GC) after total gastrectomy (TGE) depending on the reconstruction method — with or without restoration of passage through the duodenum.

MATERIAL AND METHODS

The study included 55 patients with GC after TGE, divided into 2 groups: I — with restoration (n=29); II — without restoration of duodenal passage (n=26). The dynamics of body weight, body mass index, somatometric parameters, the level of total protein, albumin, transferrin, and the absolute number of lymphocytes were assessed. CT morphometry of adipose and muscle tissue was performed, and the skeletal muscle index L₃ was calculated. Statistical analysis was performed using the IBM^® SPSS Statistics 23.0 for Windows software package.

RESULTS

Body weight as a percentage of the initial value after 12 months was 87.4±13.1 in Group I compared to 79.4±16.9 in Group II (p=0.020). The intergroup difference in BMI also reached a statistically significant level after 12 months. There were intergroup differences in the thickness of the skin-fat fold above the triceps — significantly higher in Group I at all times. The values of total protein, albumin, and lymphocytes did not differ at any of the times. The transferrin level was higher in Group I after 6 and 12 months, and the average nutritional risk index value was higher in patients of Group II at 12 months. CT morphometry of muscle tissue in dynamics did not reveal statistically significant differences between the groups, morphometry of adipose tissue showed reliable differences in the thickness of deep and superficial adipose tissue 12 months after surgery in favor of Group I.

CONCLUSION

Comparative assessment of the dynamics of nutritional status in patients with gastric cancer after total gastrectomy depending on the reconstruction method indicates the advantages of the technique with restoration of passage through the duodenum by the Double tract method.