2023 年 57 巻 3 号 p. 81-
Introduction:We investigated the effects of an oral elemental nutritional supplement(ELENTALⓇ:ED)on weight
loss in the early and long-term postoperative periods and on skeletal muscle mass loss(KSES-001, 002, and 003 studies).
Methods:One hundred eleven gastric cancer patients who underwent R0 total gastrectomy(TG)or distal gastrectomy(
DG)were randomized into two groups:an ED group of 58 patients who received an elemental nutritional supplement(
300 kcal/day)in addition to usual diet for 6-8 weeks after surgery, and a control group(C group, 53 patients)
who received only their usual diet. The weight loss rates were compared 6-8 weeks and one year postoperatively. In addition,
lumbar skeletal muscle area at the L3 level preoperatively and 1 year postoperatively was measured using SYNAPSE
VINCENT to compare the rate of skeletal muscle loss.
Results:The rate of weight loss in the early postoperative period was ED 4.9%/C 6.6%, significantly suppressing the
rate of weight loss(P=0.047). There was a significant difference of ED 5.0%/C 9.1% after TG(P=0.012), but no difference
after DG. The weight loss rate at 1 year after surgery was ED 7.1%/C 9.1%, with no difference(P=0.171). Although,
there was a significant difference of ED 9.7%/C 15.1% after TG(P=0.015). The rate of skeletal muscle loss at 1
year after surgery was ED 8.0%/C 10.1%(P=0.357)overall;after TG;ED 12.5%/C 17.5%(P=0.196)and after DG;
ED 5.6%/C 6.2%(P=0.770), all without significant difference.
Conclusion:An oral elemental nutritional supplements early after gastrectomy significantly reduced short-term postoperative
weight loss, and in TG, also significantly reduced weight loss at 1 year postoperatively. No significant difference
in skeletal muscle loss was detected.