Aim: To investigate the factors related to post-operative complications after gastrectomy for gastric cancer.

Subjects and Methods: From September 2014 to June 2015, 104 patients who underwent elective gastrectomy for gastric cancer at our hospital were retrospectively investigated. Multivariate regression analysis was performed to correlate variables with post-operative complications. P < 0.05 was defined as being statistically significant in multiple regression analysis.

Results: A total of 82 patients underwent distal gastrectomy and 22 underwent total gastrectomy. Post-operative complications (≧Clavien-Dindo Classification grade Ⅱ) occurred in 20 out of 104 patients (19.2%). There was a statistically significant correlation between complications and lymph node metastasis (P=0.032), visceral fat volume (P=0.046), body mass index (BMI) ≧25 kg/m² (P=0.002), sarcopenic obesity (P=0.004), diminished grip strength (P=0.047), and neutrophil count (P=0.026) in univariate analysis. Multivariate analysis confirmed statistically significant correlations between complications and gender (P=0.041), age (P=0.032), chronic renal disease (P=0.014), BMI ≧25 kg/m² (P=0.006), sarcopenic obesity (P=0.021), and diminished grip strength (P=0.005).

Conclusion: A thorough preoperative examination that includes the estimated glomerular filtration rate, BMI, grip strength, visceral fat volume, and skeletal muscle mass is useful in predicting complications after gastrectomy.

Backgrounds: Specific nutrients combined with exercise are expected to prevent loss of lean body mass, and consequently prevent sarcopenia. The effects of 2 weeks of L-carnitine (LCAR) supplementation associated with branched-chain amino acid (BCAA) on energy metabolism, body composition before and after exercise and post-exercise muscle soreness were examined in normal healthy subjects.

Methods: A total of 12 young untrained healthy women were randomly assigned to 2 groups who received either 2 weeks of LCAR (1000 mg/day) associated with branched-chain amino acid and 200 kcal energy (LCAR+BCAA Group, n=6) or 200 kcal energy alone (Control Group, n=6) before the 60 min exercise. Energy substrate metabolism, body composition was examined before and after exercise and delayed-onset muscle soreness (DOMS) was evaluated using VAS scale for 3 days after exercise.

Results: Serum concentrations of free and acyl LCAR in LCAR+BCAA Group were not significantly different from those in Control group. There was no difference of body composition before and after exercise between two groups. While serum free fatty acid level in LCAR+BCAA Group 120 min after the oral ingestion of BCAA was significantly lower than in Control group, there was no difference of serum free fatty acid level just after and 60 min after exercise. DOMS in LCAR+BCAA group for 3 days after exercise was lower than in Control group.

Conclusion: Continuous LCAR with BCAA in young untrained healthy subjects caused blunted response of stimulated lipolysis in LCAR+BCAA Group after exercise.

Objective: Malignant tumors induce malnutrition through cytokines, adversely affecting patients' prognoses. We focused on preoperative skeletal muscle mass as a target for cytokines, and examined the impact on long-term outcomes of patients undergoing gastric cancer surgery.

Methods: Among 391 gastric cancer patients subjected to gastrectomy at Hamamatsu Medical Center between June 2009 and October 2016, 202 patients with the data measured preoperatively using bio impedance analysis were analyzed from the above-mentioned perspective.

Results: Each median value of preoperative skeletal muscle index (SMI: kg/m²) in male and female, i.e. 9.2 and 7.7 respectively, served as the cut-off points. Accordingly, patients were divided into either the low or high-SMI groups. Five-year cause-specific survival rates of the high- and low SMI groups were 90.4 and 69.8%, respectively (p<0.01). In patients with pathological stage Ⅱ/Ⅲ diseases, low SMI was identified as an independent factor for poor survival as incomplete adjuvant chemotherapy.

Conclusions: In gastric cancer patients with stage Ⅱ/Ⅲ diseases, higher preoperative skeletal muscle mass as well as adjuvant chemotherapy were promising to improve the long-term survival outcome.