410. IMPACT ON BODY WEIGHT OF REMNANT STOMACH PRESERVING ESOPHAGECTOMY FOR THE PATIENTS WITH PAST MEDICAL HISTORY OF GASTRECTOMY

Abstract

Abstract Background Esophagectomy has a great impact on patients’ nutritional status. Particularly for the patients with past medical history of gastrectomy, there is a concern that surgical procedure of esophagectomy accommpanying remnant gastrectomy may potentially deteriorate nutritional status more than standard esophagectomy, resulting in excessive body weight loss. In order to reduce such negative impact, we perform remnant stomach preserving esophagectomy. The purpose of this study is to assess the impact on body weight of this procedure. Methods The patients with past medical history of gastrectomy who underwent remnant stomach preserving esophagectomy in our institute from 2015 to 2022 were enrolled in this study. All the measured body weights were collected from the electronic medical record retrospectively and all data point were plotted as BMI over time to see any transitional trend. The day of esophagectomy was defined as day0. The enrolled patients were divided into two groups according to the median initial BMI; lower BMI group and higher BMI group. The BMI transitional trends were detected in each group. Results Totally 37 patients were eligible in this study. Median age was 72 (57–88), the number of female was 1 (36 male), cStage1/2/3/4 of esophageal cancer were 9/9/13/5, median time period from gastrectomy was 21.0 years (0–54.5), and median initial BMI was 20.7 (15.1–27.7). All BMI data points from every patient according to the higher/lower initial BMI groups were shown in the figure. The decreasing trend in BMI until about 3 months after the esophagectomy was seen in the higher BMI group whilst relatively plateau trend in such period was seen in the lower BMI group. Conclusion Efficacy of the remnant stomach preserving esophagectomy in terms of reducing body weight loss could be more apparent in lower BMI patients than higher BMI patients. When you see an esophageal cancer patient with past medical history of gastrectomy, the remnant stomach preserving procedure should be considered particularly when the BMI is low.