Background：Weight loss after gastrectomy is an important issue and nutritional maintenance is necessary, especially for the increasing number of elderly patients. In this study, we investigated the relationship between postoperative food intake and long‐term weight loss in postgastrectomy patients aged 75 years or older.Subjects and Methods：Of 88 patients who underwent gastrectomy for gastric cancer at our institute, 46 patients were aged over 75 years of age. These patients were divided into an average energy intake of more than 50％ of basal metabolic rate group, and an average energy intake of less than 50％ of basal metabolic rate group. The percentage change in body weight up to 6 months after surgery was compared between the groups.Results：In the group with higher dietary intake, the rate of weight change at 3 and 6 months postoperatively was lower, and fewer patients were receiving postoperative adjuvant chemotherapy.Conclusion：Postoperative poor food intake may predict weight loss up to 3 months postoperatively in postgastrectomy patients over 75 years of age.Elderly patients, Gastric cancer, Weight loss

　Frailty is a state of physical and cognitive decline is between the healthy state and the need for nursing care. Frailty has been reported to occur at a high rate in patients with cancer and is associated with postoperative complications such as delirium, infection, survival, and rehospitalization. In the present study, we investigated the incidence of frailty and surgical outcomes in patients who underwent surgical treatment for gastrointestinal cancer. A total of 201 patients who underwent a preoperative physical assessment at Osaka International Cancer Institute between July and September 2021 were included in this study. J‐CHS index was used to investigate the frequency of frailty and postoperative outcomes. Among the 201 patients, 27 （13％） were frail and 126 （63％） were pre‐frail. Of the 27 frail patients, 22 （81％） were elderly, which was significantly higher than that of the pre‐frail/robust patients （p＝0.004）. The median length of hospital stay was 17 （range 5‐98） days for frail patients, which is significantly longer than that of robust patients （p＜0.001）. Thirteen frail patients （48％） developed postoperative complications, which is higher than pre‐frail patients （n＝36, 29％） and robust patients （n＝6, 13％）. In addition, frailty was an independent risk factor for postoperative complications in a multivariate analysis. These findings suggest that frailty occurs at a high rate among elderly gastrointestinal cancer patients and has an impact on the length of hospital stay and the development of postoperative complications.Frailty, Sarcopenia, Gastrointestinal cancer, Colorectal cancer, Perioperative rehabilitation, and Perioperative nutritional support

Fournier’s gangrene is defined as necrotizing fasciitis centering on the vulva. We report a case of a patient with Fournier’s gangrene who underwent nutritional management intervention using a special nutritional supplement in parallel with surgical treatment. The patient had a benign course.
A 41‐year‐old man. We performed open drainage, debridement, and colostomy for Fournier’s gangrene. From the early period after surgery, the patient underwent nutrition intervention and nutrition management consisting of four phases in response to the wound healing process.
In the first phase, we administered digestive nutrients with an anti‐inflammatory effect, including docosahexaenoic acid and eicosapentaenoic acid, to control infection risk.
In the second phase, a beverage containing hydroxymethylbutyrate was added for treating the wound and protein assimilation.In the third phase, more than twice the optimum amount of energy was consumed for the purpose of protein synthesis needed for granulation of the wound.
In the fourth phase, we administered a collagen peptide drink to improve the synthesis of epithelial tissue.
By gradual nutritional management based on the patient’s clinical condition and treatment process, the skin graft was well‐engrafted and it exhibited healing promotion effect.Necrotizing fasciitis, Fournier gangrene, Early nutrition management, Wound healing, Nutrients, Dietary supplement