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Method of reconstruction governs iron metabolism after gastrectomy for patients with gastric cancer.

 Lee, Joong Ho  ;  Hyung, Woo Jin  ;  Kim, Hyoung-Il  ;  Kim, Yoo-Min  ;  Son, Taeil  ;  Okumura, Naoki  ;  Hu, Yanfeng  ;  Kim, Choong-Bai  ;  Noh, Sung Hoon 
 Annals of Surgery, Vol.258(6) : 964-969, 2013 
Journal Title
 Annals of Surgery 
Issue Date
OBJECTIVE: Anemia after gastrectomy is commonly neglected by clinicians despite being an important and frequent long-term metabolic sequela. We hypothesized that the incidence and timing of the occurrence of iron deficiency after gastrectomy is closely associated with the extent of gastrectomy and the reconstruction method, and we investigated the treatment outcomes of iron supplementation to understand iron metabolism and determine the optimal reconstruction method after gastrectomy. PATIENTS AND METHODS: Using a prospective gastric cancer database, we identified 381 patients with early gastric cancer with complete hematologic parameters who underwent gastrectomy between January 2004 and May 2008. Kaplan-Meier methods, Cox regression, and logistic regression were used to evaluate the associations of the extent of gastrectomy and reconstruction method with iron metabolism. RESULTS: The prevalence of iron deficiency 3 years after gastrectomy was 69.1%, and iron-deficiency anemia was observed in 31.0% of patients. Iron deficiency developed in 64.8% and 90.5% of patients after distal gastrectomy and total gastrectomy within 3 years after surgery (P < 0.0001), respectively. Iron deficiency was significantly more frequent in women than in men (P < 0.0001) and after gastrojejunostomy than after gastroduodenostomy (P < 0.0001). Serum ferritin levels were different according to the extent of gastrectomy and reconstruction method. The proportion of patients treated for iron-deficiency anemia was also significantly different according to the extent of gastrectomy (P = 0.020). CONCLUSIONS: Iron deficiency occurs in most patients with gastric cancer after gastrectomy, and its incidence was different according to the extent of gastrectomy and reconstruction method. To improve iron metabolism after distal gastrectomy, gastroduodenostomy would be the method of reconstruction whenever possible.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yoo Min(김유민)
Kim, Choong Bai(김충배)
Kim, Hyoung Il(김형일) ORCID logo https://orcid.org/0000-0002-6134-4523
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Son, Tae Il(손태일) ORCID logo https://orcid.org/0000-0002-0327-5224
Lee, Joong Ho(이중호)
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
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