抄録
Body weight loss is an inevitable and serious problem after gastrectomy. Recent reports documented that weight loss of 15 per cent or more, and loss of lean body mass of at least 5 per cent at 1 month after surgery were independent risk factors for the discontinuation of adjuvant chemotherapy with S-1 after gastrectomy. Therefore, weight loss, which is the most reliable indicator of malnutrition, leads to not only a decline in postoperative quality of life, but also a worse survival. Based on such backgrounds described above, Japanese gastric surgeons have paid attention to nutritional counseling and oral nutritional supplements （ONS）. Four interventional studies using （ONS）, 2 randomized controlled trials （RCTs） and 2 single arm studies, were reported in major articles. One RCT showed the efficacy of an oral elemental diet （Elental™） in reducing postoperative weight loss. Meanwhile, another RCT using eicosapentaenoic acid （EPA）-rich nutrition as perioperative oral immunonutrition did not demonstrate any preventive effect of EPA immunonutrition on body weight loss after gastrectomy. Thus, there have been no consolidated nutritional intervention with ONS after gastrectomy. Now, we designed the large-sized RCT （500 patients as control vs. 500 patients with n-3 rich ONS （Racol™） after gastrectomy） and finished the all patients enrollment. In this joint session, we’d like to present the Japanese evidence with regard to ONS for patients with gastrectomy, including our preliminary data of our trials and to discuss how to deal with body weight loss after gastrectomy.
