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CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ |
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Česky / Czech version | Vnitř. Lék., 49, 2003, No. 3, p. 194 - 199 |
Osseous
Changes in Patients after Partial Gastrectomy Payer J.1 jun., Šteňová E.1, Killinger Z.1, Huorka M.1, Kratochvíľová H.1,Ondrejka P.2 1I. interná klinika Lekárskej fakulty UK a FN, Bratislava, Slovenská republika, prednosta prof. MUDr. I. Ďuriš, DrSc.2Nemocnica s poliklinikou Ministerstva vnútra SR, Bratislava, Slovenská republika, riaditeľMUDr. R. Uhliar, CSc. |
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Summary: Metabolic diseases of the bones may be a serious complication of gastrectomy. The pathogenesis
of osseous changes is multifactorial. The most important causes include a reduced intake of dairy
products, their fastened passage through the stomach and reduced calcium and vitamin D absorption.
The objective of the work was to assess bone changes in patients after partial gastrectomy. From
a total number of 261 patients with a minimal 10-year history of gastrectomy, in the investigation
31 patients were included (18 men and 13 women) who met the required criteria. The results were
compared with a control group of 18 men and 13 women of equal age. The authors compared also
groups of patients with the condition after surgery type Billroth I (8 patients) and Billroth II (23
patients). In all investigated subjects the authors examined the bone density in the area of the
lumbar spine and neck of the femur and parameters of osteoresorption and osteoformation.The
authors found a significant reduction of bone density in the area of the spine and neck of the
femur (p < 0.001) and a significantly higher level of total alkaline phosphatase and intact parathormone
in serum and N-terminal telopeptide collagen type I in urine (p < 0.001), as compared
with the control group. The other parameters did not differ in the investigated groups. The
authors did not find a statistically significant difference in the investigated parameters between
patients after resection Billroth I and Billroth II. The results confirm the need of early diagnosis
and treatment of bone changes in patients after partial gastrectomy.
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