Vitamin E malabsorption and neurological consequences after gastrectomy for gastric cancer.
OBJECTIVE
In order to clarify vitamin E malabsorption after gastric surgery, we evaluated serum vitamin E level and neurological consequences in patients who had undergone gastrectomy for gastric cancer.


METHODS
We studied forty-eight patients (30 men, 18 women) with a mean age of 68.0 years, who had previously undergone gastrectomy for gastric cancer and had no evidence of recurrence. The types of operation consisted of subtotal gastrectomy in 26 patients and total gastrectomy in 22 patients. We measured postoperative body weight, white blood cells, red blood cells, hemoglobin, hematocrit, platelets, and serum levels of vitamins E, vitamin B12, folic acid, total cholesterol, triglycerides, total protein, and albumin.


RESULTS
Serum vitamin E level was decreased in 7 (14.6%) of the 48 patients. The occurrence of low vitamin E level was significantly more frequent in the total gastrectomy group than in the subtotal gastrectomy group. In relation to reconstruction procedures, the incidence of low vitamin E level was significantly higher in patients without food passage through the duodenum. The low vitamin E level was significantly associated with low total cholesterol level. The incidence of neuropathy was significantly higher in patients with low vitamin E level.


CONCLUSIONS
We assume that vitamin E deficiency more likely occurs after the reconstruction procedure in which food does not pass through the duodenum. Transport disturbance with loss of passage through the duodenum consequently may be the major cause of malabsorption. Differential diagnosis of neurological symptoms in post-gastrectomy patients should include hypovitaminosis E.
Rino
Yasushi
Y
Department of Surgery, Yokohama City University School of Medicine, Yokohama, Japan. rino@med.yokohama-cu.ac.jp
Suzuki
Yume
Y
Kuroiwa
Yoshiyuki
Y
Yukawa
Norio
N
Saeki
Hiroyuki
H
Kanari
Masahiro
M
Wada
Hiroo
H
Ino
Hiroyo
H
Takanashi
Yoshinori
Y
Imada
Toshio
T
D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D008286:Malabsorption Syndromes / Q000150:complications / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis / Q000209:etiology*; D011178:Postgastrectomy Syndromes / Q000150:complications / Q000209:etiology; D011183:Postoperative Complications; D012044:Regression Analysis; D013274:Stomach Neoplasms / Q000473:pathology*; D016896:Treatment Outcome; D014805:Vitamin B 12 / Q000378:metabolism; D014810:Vitamin E / Q000378:metabolism*
D014810:Vitamin E; D014805:Vitamin B 12