Total gastrectomy and malnutrition [Gastrectomia totale e malnutrizione]

BACKGROUND: The operation more frequently performed for gastric malignancy is total gastrectomy. METHODS: Our reconstructive technique is Roux en Y esophago-jejunostomy, jejunal interposition after gastrectomy. In the next weeks after operation there is always an important, sometimes pathologic, slimming in gastrectomized patients. But is this slimming due to malnutrition or malabsorption? This is the real question. In our Institute a quarterly perspective clinical and instrumental follow-up for these patients has been prepared. RESULTS: We started with 41 patients, but we conducted the complete study only on 23. Of these patients, 56% have lost 10 kg weight, 25% 5 kg and 18% have not lost weight after 2 weeks from discharge dimission. But after 5 weeks, all patients had stabilized their own weight, and 18 months later the first two groups regained weight again, 1-2 kg. With our follow-up, we had educated patients to a correct personal natural diet necessary to normal social and working life. With our program in 3-4 weeks the weight of each patient was stable and we were able to control the malabsorption. CONCLUSIONS: Moreover, according to personal experience, it is important to plan a follow-up to rehabilitate patients to usual social life. This program allows to evaluate malnutrition and the possible iron or vit. B12 deficiency.