[Protein-energy malnutrition in the gastrectomized patient].
BACKGROUND
Gastrectomy leads to nutritional consequences that although expected, are not usually measured due to methodological limitations.


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


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.


CONCLUSIONS
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.
Centro de Metabolismo e Nutrição (CeMeNutri), Faculdade de Medicina, Universidade Estadual de São Paulo, UNESP, Botucatu, SP.
Silvia Justina
SJ
Papini-Berto
Regiane
R
Maio
Ana Karia
AK
Módolo
Maria Dorotéia Borges
MD
dos Santos
Isaias
I
Dichi
Roberto Carlos
RC
Burini
D000328:Adult; D000368:Aged; D000886:Anthropometry; D001938:Brazil / Q000453:epidemiology; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D005770:Gastrointestinal Neoplasms / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010437:Peptic Ulcer / Q000601:surgery; D015995:Prevalence; D011502:Protein-Energy Malnutrition / Q000453:epidemiology / Q000209:etiology*; D015431:Weight Loss