Dong Jin Park

Actual 5-Year Nutritional Outcomes of Patients with Gastric Cancer

Purpose In this study, we aimed to evaluate the rarely reported long-term nutritional results of patients with gastric cancer after curative gastrectomy. Materials and Methods We retrospectively reviewed the prospectively collected medical records of 658 patients who underwent radical gastrectomy with curative intent for gastric cancer from January 2008 to December 2009 and had no recurrences. All patients were followed for 5 years. Nutritional statuses were assessed using measurements of body weight, serum hemoglobin, total lymphocyte count (TLC), protein, albumin, cholesterol, and nutritional risk index (NRI). Results Patients who underwent total gastrectomy had lower body weights, hemoglobin, protein, albumin, and cholesterol levels. TLC and NRI valued after the first postoperative year (P<0.05), and lower hemoglobin and NRI valued during the fifth postoperative year than patients who underwent distal gastrectomy (P<0.05). Patients who received adjuvant chemotherapy after gastrectomy had lower hemoglobin, protein, albumin, and cholesterol levels. TLC and NRI valued during the first postoperative year, than those who underwent gastrectomy only (P<0.05). Regarding post-distal gastrectomy reconstruction, those who underwent Roux-en-Y had lower cholesterol levels than did those who underwent Billroth-I and Billroth-II reconstruction at the first and fifth years after gastrectomy, respectively (P<0.05). Conclusions Patients undergoing total or distal gastrectomy with Roux-en-Y anastomosis or adjuvant chemotherapy after surgery should be monitored carefully for malnutrition during the first postoperative year, and patients undergoing total gastrectomy should be monitored for malnutrition and anemia for 5 years.

Case Report: Gastrobronchial Fistula after Sleeve Gastrectomy: Treated by Laparoscopic Proximal Gastrectomy with Double Tract Reconstruction

Laparoscopic sleeve gastrectomy is one of the most popular procedure for the treatment of morbid obesity. Postoperative bronchogastric fistula is very rare and difficult to manage. This complication requires multiple radiological, endoscopic, and surgical procedures. We report here the case of a 28 years old foreign woman who underwent laparoscopic sleeve gastrectomy for morbid obesity in her contury. She complained of a cough with fever and was diagnosed a postoperative bronchogastric fistula. After failure of conservative treatment, she wanted to treat at our hospital. First of all, we inserted a stent for the fistula, however, it failed to treatment. And then, we performed a thoracoscopic segmentectomy and laparoscopic proximal gastrectomy with double tract reconstruction.