Feasibility of Oral Vitamin B12 Supplementation After Total Gastrectomy: Single Institution Cohort
Journal Title: Journal of Surgery Research and Practice - Year 2025, Vol 6, Issue 1
Abstract
Objective: Vitamin-B12 (VB12) deficiency is a severe long-term risk for patients following Total Gastrectomy (TG). The absence of intrinsic factor secretion from gastric parietal cells often mandates parenteral administration, which can be costly and inconvenient to patients. However, recent data suggests the convenient oral route of administration is just as effective. This study evaluates our group’s experience with exclusive oral VB12 supplementation post-TG. Methods: Conducted as an IRB-approved retrospective cohort analysis, the study included TG-patients treated at a tertiary cancer center from 2014 through 2021. The primary comparison was between oral and other routes of administration, with outcomes measuring postoperative serum-VB12 and hemoglobin till 3 years post-TG. Longitudinal analysis assessed possible associations between routes and patient outcomes. Results: 52 TG-patients were identified (median age 61-years; male 54%). Most (n=43,83%) received exclusive oral-VB12, while the remaining received parenteral (IM n=6, SubQ n=1) or a combination (n=2, oral+parenteral). At 6-months, 1-year, 2-years and 3-years post-TG, 80% (n=39/49), 68% (n=30/44), 71% (n=24/34) and 50% (n=8/16) of patients, respectively, maintained complete oral supplementation. Mean-VB12 levels for oral administration were 1085 (n=16), 967 (n=19) and 1012 (n=18) pg/mL at 6-months, 1-year and 2-years, respectively. At 2-years, the mean-hemoglobin level was 12.4 (n=23) and the mean-corpuscular-volume was 90.8 (n=18), with no association between route and these two parameters. Conclusion: Oral VB12 administration is a safe, feasible and convenient long-term supplementation route for patients after TG, however, VB12 levels need to be monitored long term.
Authors and Affiliations
Sarah R Bradley1, Mathew J Gregoski2, Ryan J Mcfadden3, Thomas C Geiger1, Jonathan Pire1, Sara S Van Nortwick1, Matthew A Dow1, Robert F Murphy1*
Keywords
Related Articles
- EP ID EP755265
- DOI https://doi.org/10.46889/JSRP.2025.6102
- Views 5
- Downloads 0
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