J.Jpn. Surg. Soc.. 61(4): 525-550, 1960
NUTRITIONAL PROBLEMS FOLLOWING TOTAL GASTRECTOMY COMBINED WITH RESECTIONS OF THE ADJACENT ORGANS
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Nakayama Surgical Department, Chiba University Yasunori YAMASHITA |
In this experiment , for obtaining absorption rate, the author used the Ratio Method using chromic oxide, which was introduced recently and adapted to medical research from stockbreeding, and has several advantageous points over the conventional Total Collection Method.
Through thorough investigation, the author could draw the following conclusions:
(1) The diminished functions of digestion and absorption due to removal of the important gastro-intestinal organs are not of lethal degree. They were found to rise or, at least, not to fall to the absolute lethal degree, which is indicated as less thah 40% of protein absorption rate and 60% of totel absorption rate, when the adequate postoperative treatment was given.
Desirous points concerning adequate postoperative treatmant are as follows:
(a) Consider especially the low absorption rate of fat and treat it within a couple of months after total gestrectomy combined with resection of the tail of the pancreas and splenectomy.
(b) It is necessary to pay much attention and treat the low absorption rates of both protein and fat following total gastrectemy combined with resections of the tail of the pancreas, transverse colon and splenectomy, even in the follow-up period.
(c) Administration of digestive enzymatic medicines. cholagogues and emulsive agents of fat are recommended in those patients in a postoperative status. And the importance of supplying plenty of calcium to these patients should be stressed.
(d) Postoperative feeding should be conducted according to the respective physiopathology of the postoperative patient after each type of surgery. The average status of respective physiopathology of each surgery type such as total gastrectomy combined with resection of the tail of the pancreas and splenectomy, and total gastrectomy combined with resection of the tail of the pancreas, transverse colon and splenectomy, etc. are discussed in the main thesis
(2) From the evidence obtained by this investigation the following interesting findings have been drawn :
(a) In the large bowel which does not absorb any organic substances in the normal animal, about 7 to 9% of administered amounts of protein and fat are absorbed in the follow-up period after removal of the upper digestive organs.
(b) Following total gastrectomy which combines removal of the tail of the pancreas, the function of the residual pancreas can compensate and rise to the same level as after simple total gastrectomy.
If the above summarized facts are observed in the postoperative treatment of those patients who undergo combined resection of the stomach and adjacent organs. then this type of radical surgary may represent significant progress in the treatment of advanced stomach cancer.
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