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Erschienen in: Indian Journal of Surgery 6/2010

01.12.2010 | Original Article

Nutritional Assessment of Patients After Pylorus-Preserving Gastrectomy for Early Gastric Cancer

verfasst von: Masahide Ikeguchi, Hirohiko Kuroda, Kyouichi Kihara, Tomoko Hatata, Tomoyuki Matsunaga, Kenji Fukuda, Hiroaki Saito, Shigeru Tatebe

Erschienen in: Indian Journal of Surgery | Ausgabe 6/2010

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Abstract

The aim of this study was to evaluate the nutritional advantages of pylorus-preserving gastrectomy (PPG) in comparison with distal gastrectomy with Billroth I anastomosis (DG) in early gastric cancer (EGC). Between 2005 and 2007, 24 patients underwent PPG and 30 underwent DG. Subjective global assessment, objective data assessment, and endoscopic findings of the remnant stomach were compared between the two groups. Two years after surgery, the patients’ body weights recovered to 97% in PPG, but they continued to decrease in DG. Postoperative blood lymphocyte counts remained low in DG, but recovered to preoperative levels 6 months after surgery in PPG. Food residue in the gastric remnant was frequently observed in PPG (71.4%) than in DG (15.8%, P = 0.001). In nutritional aspect, PPG may be a more ideal operation than DG. However, food residue in the gastric remnant should be considered in PPG.
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Literatur
1.
Zurück zum Zitat Katsube T, Konnno S, Murayama M, Kuhara K, Sagawa M, Yoshimatsu K, Shiozawa S, Shimakawa T, Naritaka Y, Ogawa K (2008) Changes of nutritional status after distal gastrectomy in patients with gastric cancer. Hepatogastroenterology 55:1864–1867PubMed Katsube T, Konnno S, Murayama M, Kuhara K, Sagawa M, Yoshimatsu K, Shiozawa S, Shimakawa T, Naritaka Y, Ogawa K (2008) Changes of nutritional status after distal gastrectomy in patients with gastric cancer. Hepatogastroenterology 55:1864–1867PubMed
2.
Zurück zum Zitat Maki T, Shiratori T, Hatafuku T, Sugawara K (1967) Pylorus-preserving gastrectomy as an improved operation for gastric ulcer. Surgery 61:838–845PubMed Maki T, Shiratori T, Hatafuku T, Sugawara K (1967) Pylorus-preserving gastrectomy as an improved operation for gastric ulcer. Surgery 61:838–845PubMed
3.
Zurück zum Zitat Morita S, Katai H, Saka M, Fukagawa T, Sano T, Sasako M (2008) Outcome of pylorus-preserving gastrectomy for early gastric cancer. Br J Surg 95:1131–1135PubMedCrossRef Morita S, Katai H, Saka M, Fukagawa T, Sano T, Sasako M (2008) Outcome of pylorus-preserving gastrectomy for early gastric cancer. Br J Surg 95:1131–1135PubMedCrossRef
4.
Zurück zum Zitat Japanese Gastric Cancer Association (1998) Japanese classification of gastric carcinoma. 2nd English ed. Gastric Cancer 1:10–24PubMedCrossRef Japanese Gastric Cancer Association (1998) Japanese classification of gastric carcinoma. 2nd English ed. Gastric Cancer 1:10–24PubMedCrossRef
5.
Zurück zum Zitat Baccaro F, Moreno JB, Borlenghi C, Aquino L, Armesto G, Plaza G, Zapata S (2007) Subjective global assessment in the clinical setting. J Parenter Enteral Nutr 31:406–409CrossRef Baccaro F, Moreno JB, Borlenghi C, Aquino L, Armesto G, Plaza G, Zapata S (2007) Subjective global assessment in the clinical setting. J Parenter Enteral Nutr 31:406–409CrossRef
6.
Zurück zum Zitat Lundell LR, Dent J, Bennett JR, Blum AL, Armstrong D, Galmiche JP, Johnson F, Hongo M, Richter JE, Spechler SJ, Tytgat GN, Wallin L (1999) Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut 45:172–180PubMedCrossRef Lundell LR, Dent J, Bennett JR, Blum AL, Armstrong D, Galmiche JP, Johnson F, Hongo M, Richter JE, Spechler SJ, Tytgat GN, Wallin L (1999) Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut 45:172–180PubMedCrossRef
7.
Zurück zum Zitat Kubo M, Sasako M, Gotoda T, Ono H, Fujishiro M, Saito D, Sano T, Katai H (2002) Endoscopic evaluation of the remnant stomach after gastrectomy: proposal for a new classification. Gastric Cancer 5:83–89PubMedCrossRef Kubo M, Sasako M, Gotoda T, Ono H, Fujishiro M, Saito D, Sano T, Katai H (2002) Endoscopic evaluation of the remnant stomach after gastrectomy: proposal for a new classification. Gastric Cancer 5:83–89PubMedCrossRef
8.
Zurück zum Zitat Zhang D, Shimoyama S, Kaminishi M (1998) Feasibility of pylorus-preserving gastrectomy with a wider scope of lymphadenectomy. Arch Surg 133:993–997PubMedCrossRef Zhang D, Shimoyama S, Kaminishi M (1998) Feasibility of pylorus-preserving gastrectomy with a wider scope of lymphadenectomy. Arch Surg 133:993–997PubMedCrossRef
9.
Zurück zum Zitat Nakane Y, Akehira K, Inoue K, Iiyama H, Sato M, Masuya Y, Okumura S, Yamamichi K, Hioki K (2000) Postoperative evaluation of pylorus-preserving gastrectomy for early gastric cancer. Hepatogastroenterology 47:590–595PubMed Nakane Y, Akehira K, Inoue K, Iiyama H, Sato M, Masuya Y, Okumura S, Yamamichi K, Hioki K (2000) Postoperative evaluation of pylorus-preserving gastrectomy for early gastric cancer. Hepatogastroenterology 47:590–595PubMed
10.
Zurück zum Zitat Shibata C, Shiiba KI, Funayama Y, Ishii S, Fukushima K, Mizoi T, Koyama K, Miura K, Matsuno S, Naito H, Kato E, Honda T, Momono S, Ouchi A, Ashino Y, Takahashi Y, Fujiya T, Iwatsuki A, Sasaki I (2004) Outcomes after pylorus-preserving gastrectomy for early gastric cancer: a prospective multicenter trial. World J Surg 28:857–861PubMedCrossRef Shibata C, Shiiba KI, Funayama Y, Ishii S, Fukushima K, Mizoi T, Koyama K, Miura K, Matsuno S, Naito H, Kato E, Honda T, Momono S, Ouchi A, Ashino Y, Takahashi Y, Fujiya T, Iwatsuki A, Sasaki I (2004) Outcomes after pylorus-preserving gastrectomy for early gastric cancer: a prospective multicenter trial. World J Surg 28:857–861PubMedCrossRef
11.
Zurück zum Zitat Hotta T, Taniguchi K, Kobayashi Y, Johata K, Sahara M, Naka T, Terashita S, Yokoyama S, Matsuyama K (2001) Postoperative evaluation of pylorus-preserving procedures compared with conventional distal gastrectomy for early gastric cancer. Surg Today 31:774–779PubMedCrossRef Hotta T, Taniguchi K, Kobayashi Y, Johata K, Sahara M, Naka T, Terashita S, Yokoyama S, Matsuyama K (2001) Postoperative evaluation of pylorus-preserving procedures compared with conventional distal gastrectomy for early gastric cancer. Surg Today 31:774–779PubMedCrossRef
12.
Zurück zum Zitat Park DJ, Lee H-J, Jung HC, Kim WH, Lee KU, Yang H-K (2008) Clinical outcome of pylorus-preserving gastrectomy in gastric cancer in comparison with conventional distal gastrectomy with Billroth I anastomosis. World J Surg 32:1029–1036CrossRef Park DJ, Lee H-J, Jung HC, Kim WH, Lee KU, Yang H-K (2008) Clinical outcome of pylorus-preserving gastrectomy in gastric cancer in comparison with conventional distal gastrectomy with Billroth I anastomosis. World J Surg 32:1029–1036CrossRef
13.
Zurück zum Zitat Milasiene V, Stratilatovas E, Norkiene V, Jonusauskaite R (2005) Lymphocyte subsets in peripheral blood as prognostic factors in colorectal cancer. J BUON 10:261–264PubMed Milasiene V, Stratilatovas E, Norkiene V, Jonusauskaite R (2005) Lymphocyte subsets in peripheral blood as prognostic factors in colorectal cancer. J BUON 10:261–264PubMed
14.
Zurück zum Zitat Fogar P, Sperti C, Basso D, Sanzari MC, Greco E, Davoli C, Navaglia F, Zambon CF, Pasquali C, Venza E, Pedrazzoli S, Plebani M (2006) Decreased total lymphocyte counts in pancreatic cancer: an index of adverse outcome. Pancreas 32:22–28PubMedCrossRef Fogar P, Sperti C, Basso D, Sanzari MC, Greco E, Davoli C, Navaglia F, Zambon CF, Pasquali C, Venza E, Pedrazzoli S, Plebani M (2006) Decreased total lymphocyte counts in pancreatic cancer: an index of adverse outcome. Pancreas 32:22–28PubMedCrossRef
15.
Zurück zum Zitat Hong WS, Hong SI, Kim CM, Kang YK, Song JK, Lee MS, Lee JO, Kang TW (1991) Differential depression of lymphocyte subsets according to stage in stomach cancer. Jpn J Clin Oncol 21:87–93PubMed Hong WS, Hong SI, Kim CM, Kang YK, Song JK, Lee MS, Lee JO, Kang TW (1991) Differential depression of lymphocyte subsets according to stage in stomach cancer. Jpn J Clin Oncol 21:87–93PubMed
16.
Zurück zum Zitat Gwak MS, Choi SJ, Kim JA, Ko JS, Kim TH, Lee SM, Park JA, Kim MH (2007) Effects of gender on white blood cell populations and neutrophil-lymphocyte ratio following gastrectomy in patients with stomach cancer. J Korean Med Sci 22(Suppl):S104–S108PubMedCrossRef Gwak MS, Choi SJ, Kim JA, Ko JS, Kim TH, Lee SM, Park JA, Kim MH (2007) Effects of gender on white blood cell populations and neutrophil-lymphocyte ratio following gastrectomy in patients with stomach cancer. J Korean Med Sci 22(Suppl):S104–S108PubMedCrossRef
17.
Zurück zum Zitat Jung IK, Kim MC, Kim KH, Kwak JY, Jung GJ, Kim HH (2008) Cellular and peritoneal immune response after radical laparoscopy-assisted and open gastrectomy for gastric cancer. J Surg Oncol 98:54–59PubMedCrossRef Jung IK, Kim MC, Kim KH, Kwak JY, Jung GJ, Kim HH (2008) Cellular and peritoneal immune response after radical laparoscopy-assisted and open gastrectomy for gastric cancer. J Surg Oncol 98:54–59PubMedCrossRef
18.
Zurück zum Zitat Imada T, Rino Y, Takahashi M, Hatori S, Tanaka J, Shiozawa M, Chin C, Yamamoto Y, Amano T, Nakamura K (1998) Gastric emptying after pylorus-preserving gastrectomy in comparison with conventional subtotal gastrectomy for early gastric carcinoma. Surg Today 28:135–138PubMedCrossRef Imada T, Rino Y, Takahashi M, Hatori S, Tanaka J, Shiozawa M, Chin C, Yamamoto Y, Amano T, Nakamura K (1998) Gastric emptying after pylorus-preserving gastrectomy in comparison with conventional subtotal gastrectomy for early gastric carcinoma. Surg Today 28:135–138PubMedCrossRef
19.
Zurück zum Zitat Nunobu S, Sasako M, Saka M, Fukagawa T, Katai H, Sano T (2007) Symptom evaluation of long-term postoperative outcomes after pylorus-preserving gastrectomy for early gastric cancer. Gastric Cancer 10:167–172CrossRef Nunobu S, Sasako M, Saka M, Fukagawa T, Katai H, Sano T (2007) Symptom evaluation of long-term postoperative outcomes after pylorus-preserving gastrectomy for early gastric cancer. Gastric Cancer 10:167–172CrossRef
20.
Zurück zum Zitat Nishikawa K, Kawahara H, Yumiba T, Nishida T, Inoue Y, Ito T, Matsuda H (2002) Functional characteristics of the pylorus in patients undergoing pylorus-preserving gastrectomy for early gastric cancer. Surgery 131:613–624PubMedCrossRef Nishikawa K, Kawahara H, Yumiba T, Nishida T, Inoue Y, Ito T, Matsuda H (2002) Functional characteristics of the pylorus in patients undergoing pylorus-preserving gastrectomy for early gastric cancer. Surgery 131:613–624PubMedCrossRef
21.
Zurück zum Zitat Nagano H, Ohyama S, Sakamoto Y, Ohta K, Yamaguchi T, Muto T, Yamaguchi A (2004) The endoscopic evaluation of gastric remnant residue, and the incidence of secondary cancer after pylorus-preserving and transverse gastrectomies. Gastric Cancer 7:54–59PubMedCrossRef Nagano H, Ohyama S, Sakamoto Y, Ohta K, Yamaguchi T, Muto T, Yamaguchi A (2004) The endoscopic evaluation of gastric remnant residue, and the incidence of secondary cancer after pylorus-preserving and transverse gastrectomies. Gastric Cancer 7:54–59PubMedCrossRef
22.
Zurück zum Zitat Tsujii H, Andoh S, Sakakibara K (2003) The clinical evaluation of vagus nerve preserving gastric operation with D2 lymph node dissection for early and advanced gastric cancer (in Japanese). Jpn J Gastroenterol Surg 36:78–84CrossRef Tsujii H, Andoh S, Sakakibara K (2003) The clinical evaluation of vagus nerve preserving gastric operation with D2 lymph node dissection for early and advanced gastric cancer (in Japanese). Jpn J Gastroenterol Surg 36:78–84CrossRef
Metadaten
Titel
Nutritional Assessment of Patients After Pylorus-Preserving Gastrectomy for Early Gastric Cancer
verfasst von
Masahide Ikeguchi
Hirohiko Kuroda
Kyouichi Kihara
Tomoko Hatata
Tomoyuki Matsunaga
Kenji Fukuda
Hiroaki Saito
Shigeru Tatebe
Publikationsdatum
01.12.2010
Verlag
Springer-Verlag
Erschienen in
Indian Journal of Surgery / Ausgabe 6/2010
Print ISSN: 0972-2068
Elektronische ISSN: 0973-9793
DOI
https://doi.org/10.1007/s12262-010-0167-4

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