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Malnutrition in these patients can manifest both before and after surgery, due to factors such as gastric outlet obstruction, cancer cachexia, and anatomical changes. Notably, total gastrectomy (TG) presents the most significant nutritional challenges. However, function\u2010preserving gastrectomy, such as pylorus\u2010preserving gastrectomy (PPG) and proximal gastrectomy (PG), have shown promise in improving nutritional outcomes. Effective nutritional risk screening and assessment are vital for identifying patients at risk. Nutritional support not only improves nutritional parameters but also reduces complications, enhances quality of life (QoL) and survival rates. Those unable to maintain more than 50% of the recommended intake for over 7\u2009days are recommended for nutritional support. Common methods of nutritional support include oral nutrition supplements (ONS), enteral nutrition (EN), or parenteral nutrition (PN) depending on the patient's status. Effect of perioperative nutritional support remains controversial. Preoperative interventions including ONS and PN have shown mixed results, with selective benefits in patients with sarcopenia or hypoalbuminaemia, while impact of EN in gastric outlet obstruction patients have been positive. In contrast postoperative support appears to be consistent. Tube feeding after TG has shown improvements, and ONS have been effective in reducing weight loss and improving nutritional biomarkers. PN was also associated with benefits such as weight maintenance and QoL. This review explores the mechanisms, assessment, and clinical impact of malnutrition, emphasizing the importance of nutritional support in gastric cancer patients undergoing gastrectomy.<\/jats:p>","DOI":"10.1002\/ags3.12788","type":"journal-article","created":{"date-parts":[[2024,3,16]],"date-time":"2024-03-16T11:29:31Z","timestamp":1710588571000},"page":"534-552","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Impact of malnutrition and nutritional support after gastrectomy in patients with gastric cancer"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5816-5877","authenticated-orcid":false,"given":"Min Kyu","family":"Kang","sequence":"first","affiliation":[{"name":"Division of Gastrointestinal Surgery, Department of Surgery Seoul National University Hospital  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyuk\u2010Joon","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Surgery, Department of Surgery Seoul National University Hospital  Seoul South Korea"},{"name":"Department of Surgery &amp; 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