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Vitamin B12 Deficiency After Gastrectomy for Gastric Cancer: An Analysis of Clinical Patterns and Risk Factors

Authors
 Hu, Yanfeng  ;  Kim, Hyoung-Il  ;  Hyung, Woo Jin  ;  Song, Ki Jun  ;  Lee, Joong Ho  ;  Kim, Yoo Min  ;  Noh, Sung Hoon 
Citation
 ANNALS OF SURGERY, Vol.258(6) : 970-975, 2013 
Journal Title
 ANNALS OF SURGERY 
ISSN
 0003-4932 
Issue Date
2013
MeSH
Female ; Gastrectomy/adverse effects* ; Humans ; Male ; Middle Aged ; Prospective Studies ; Risk Assessment ; Risk Factors ; Stomach Neoplasms/surgery* ; Vitamin B 12 Deficiency/diagnosis ; Vitamin B 12 Deficiency/etiology*
Keywords
Female ; Gastrectomy/adverse effects* ; Humans ; Male ; Middle Aged ; Prospective Studies ; Risk Assessment ; Risk Factors ; Stomach Neoplasms/surgery* ; Vitamin B 12 Deficiency/diagnosis ; Vitamin B 12 Deficiency/etiology*
Abstract
OBJECTIVE: To identify risk factors for postgastrectomy vitamin B12 deficiency and the time course of its development. BACKGROUND: Postgastrectomy vitamin B12 deficiency worsens the quality of life of gastric cancer survivors, and vitamin B12-related neuropathy is irreversible if recognized late. However, the clinical pattern of vitamin B12 deficiency development after gastrectomy remains unclear. METHODS: We reviewed 645 patients with gastric cancer who underwent distal subtotal gastrectomy (DG; n = 469) or total gastrectomy (TG, n = 176) between 2003 and 2010. Univariate and multivariate analyses were performed to identify risk factors for vitamin B12 deficiency and time to deficiency. RESULTS: Cumulative vitamin B12 deficiency rates were 100% for TG and 15.7% for DG 4 years after surgery (P < 0.001). The median time to vitamin B12 deficiency was 15 months after TG, whereas the median time was not reached after DG. Preoperative vitamin B12 level was the only risk factor for vitamin B12 deficiency after TG, whereas both preoperative vitamin B12 level and age were risk factors after DG. There was positive linear correlation between preoperative vitamin B12 levels and the time to vitamin B12 deficiency after either TG (P < 0.001) or DG (P = 0.017). CONCLUSIONS: Vitamin B12 deficiency is an inevitable and rather early metabolic sequela after TG. Elderly patients with low preoperative vitamin B12 levels are more likely to experience vitamin B12 deficiency after DG. Thus, preoperative measurement and regular postoperative monitoring of vitamin B12 levels are necessary for early detection and treatment of postgastrectomy vitamin B12 deficiency.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00000658-201312000-00018&LSLINK=80&D=ovft
DOI
10.1097/SLA.0000000000000214
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yoo Min(김유민)
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
Song, Ki Jun(송기준) ORCID logo https://orcid.org/0000-0003-2505-4112
Lee, Joong Ho(이중호)
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/88459
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