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Background Gastrectomy results in a significant loss of body composition in the long term, but the acute skeletal muscle wasting after gastrectomy has been rarely investigated. Moreover, the association between postoperative muscle wasting and quality of life (QOL) has never been reported. In the present study, we aimed to investigate the risk factors for acute muscle wasting after gastric cancer surgery and its effect on QOL and short-term postoperative outcomes. Methods We conducted a prospective study of patients who underwent curative gastrectomy for gastric cancer between June 2015 and December 2015. Skeletal muscle mass was measured by computed tomography within 1 month before and 1 week after surgery. QOL was assessed 1, 3, and 6 months postoperatively. Univariate and multivariate analyses were performed to identify the risk factors for clinically relevant muscle wasting (muscle wasting ≥10%). Results A total of 110 patients were included, in which 35 patients had muscle wasting ≥10% within 1 week after surgery. Age ≥65 years and diabetes were independent risk factors for muscle wasting ≥10%. Patients with muscle wasting ≥10% had a poorer QOL in terms of fatigue and physical functioning at 1 and 3 months postoperatively, as well as a higher incidence of postoperative complications, a higher incidence of handgrip strength reduction ≥10%, longer hospital stays, and higher costs. Conclusions Age ≥65 years and diabetes were independently associated with clinically relevant muscle wasting within 1 week after gastric cancer surgery. Clinically relevant muscle wasting was associated with a poorer QOL and short-term outcomes after surgery. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of duodenal-jejunal bypass(DJB) and sleeve gastrectomy(SG) on the expression of liver glucokinase(GCK) in diabetic rats., Methods: Animal models of Goto-Kakizaki rats and Sprague-Dawley rats were established by DJB and SG. Results of fasting glycemia and insulin were compared. Liver tissue was harvested 8 weeks postoperatively.Quantitative real-time PCR and Western blot were used to detect liver GCK mRNA and protein expression after operation., Results: Fasting plasma glucose levels of DJB group and SG group in GK rats were markedly declined 3 day and 1, 2, 4, 6, 8 weeks postoperatively(all P <0.01), while Sham group only dropped 3 day and 1 week postoperatively, and there were no significant differences 2 weeks postoperatively(P >0.05). Fasting plasma glucose levels of each group in SD rats did not change after operation. In GK rats, GCK mRNA level (1.45 +/-0.29) and protein expression (494.25 +/-30.25) after DJB were higher than Sham group (1.05 +/-0.19 and 409.13 +/-26.86) and control group (1.04 +/-0.17 and 404.75 +/-30.90). GCK mRNA level and protein expression after SG were 0.65 +/-0.25 and 345.25 +/-28.13 respectively, which were significantly lower than those in control group(all P <0.01). All the groups in SD rats experienced similar GCK expression change., Conclusion: Both DJB and SG can decrease the plasma glucose levels of GK rats, while there are different effects on the expression of liver GCK.

Objective: To evaluate the short-term outcome of laparoscopic gastric bypass on obesity patients with type 2 diabetes mellitus., Methods: Seven obesity patients with type 2 diabetes mellitus received laparoscopic gastric bypass(n=1) or laparoscopic minigastric bypass(n=6), and their data of treatment outcomes were analyzed., Results: The operations were all successfully performed without any complications. The average operation time was 125 minutes(range: 100 to 170 minutes). The patients underwent 1-18 months follow-up after operation. Diabetic indicators returned to normal without any medication and body weight reduced by on average of 24.3 kg., Conclusion: Laparoscopic gastric bypass and minigastric bypass have good short-term outcome in the treatment of obesity patients with type 2 diabetes mellitus.

Objective: To explore the benefit of neoadjuvant chemotherapy in advanced gastric cancer patients treated by laparoscopy., Methods: Fifteen patients with histologically proved gastric adenocarcinomas (stages II(, III(, IIII(M(0)) were treated with FOLFOX7 neoadjuvant chemotherapy followed by laparoscopy between June 2005 and March 2007( trial group). Thirty patients were assigned to the control group with only laparoscopic treatment in the same period. The clinicopathological data were compared between two groups., Results: All the patients in trial group accepted four cycles of preoperative chemotherapy and the toxicity was less than grade 3. Two of them achieved complete response, 10 achieved partial response and 3 kept stable disease. Ten patients of trial group underwent laparoscopic-assisted radical gastrectomy. The rates of R(0)-resection(80.0%) and pN(0) (60.0%) in trial group were significantly higher than those in control group(46.7% and 20.0%), while the rate of positive lymph node 11.0%(34/309) was significantly lower than that of control group 23.8%(142/596). The operation time and postoperative complication were similar in two groups., Conclusions: Advanced gastric cancer after neoadjuvant chemotherapy can be down-regulated in the stage, increase the rate of R(0)-resection, diminish the infiltration extent of tumor, decrease the metastasis of lymph node, and increase the possibility of laparoscopic radical gastrectomy.