Iron deficiency anemia after subtotal gastrectomy for gastric cancer.
OBJECTIVE
Sideropenic anemia after a gastrectomy is a frequent complication. The aim of the present study was to evaluate the role of different factors, such as sex, age, atrophic chronic gastritis, Helicobacter pylori infection and iron malabsorption, in iron deficiency after surgery for gastric cancer.


METHODS
Thirty-seven patients who underwent subtotal gastrectomy for carcinoma of the stomach were prospectively studied following a specific three-year protocol. Iron deficiency was evaluated by hemochromocytometric analysis and serum iron-ferritin level assays.


RESULTS
Of the different variables analyzed, atrophic chronic gastritis was associated with a lower mean serum iron level, in particular two years after surgery (65mg/dL vs. 103 mg/dL in subjects without gastritis, P<0.01); a correlation between Helicobacter pylori infection of the gastric stump and lower mean serum ferritin level was also found (25+/-6.3 mg/dL vs. 53+/-0.4 mg/dL, P<0.05). On the contrary, no association was observed with the other factors that were evaluated.


CONCLUSIONS
Among the factors involved in iron deficiency after gastrectomy for cancer of the stomach, atrophic gastritis seems to be the most important, although Helicobacter pylori infection of the gastric stump also seems to play an important role.
Roviello
Franco
F
Department of Human Pathology and Oncology, Section of Surgical Oncology, University of Siena, Siena, Italy. roviello@unisi.it
Fotia
Giuseppe
G
Marrelli
Daniele
D
De Stefano
Alfonso
A
Macchiarelli
Raffaele
R
Pinto
Enrico
E
D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000209:etiology*; D002908:Chronic Disease; D005260:Female; D005293:Ferritins / Q000097:blood; D005500:Follow-Up Studies; D005743:Gastrectomy; D018530:Gastric Stump; D005757:Gastritis, Atrophic / Q000097:blood / Q000175:diagnosis; D016481:Helicobacter Infections / Q000097:blood / Q000175:diagnosis; D016480:Helicobacter pylori; D006801:Humans; D007501:Iron / Q000097:blood; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000601:surgery*
D005293:Ferritins; D007501:Iron