胃袋的蠕动与全胃切除术后的生活质量相关。

Motility of the pouch correlates with quality of life after total gastrectomy.

作者信息

Endo Shunji, Nishida Toshirou, Nishikawa Kazuhiro, Yumiba Takeyoshi, Nakajima Kiyokazu, Yasumasa Keigo, Kitagawa Toru, Ito Toshinori, Matsuda Hikaru

机构信息

Department of Surgery, E1, Osaka University Graduate School of Medicine, Yamadaoka, Suita-shi, Osaka, Japan.

出版信息

Surgery. 2006 Apr;139(4):493-500. doi: 10.1016/j.surg.2005.08.013.

DOI:10.1016/j.surg.2005.08.013

PMID:16627058

Abstract

BACKGROUND

Jejunal pouch reconstruction is used to provide reservoir function after total gastrectomy, but controversy remains regarding pouch functions and quality of life (QOL). In this study, pouch motility was studied in conjunction with postoperative QOL.

METHODS

Pouch motility of 23 patients with jejunal pouch interposition after total gastrectomy was examined by manometry under fasting conditions and by an emptying test using dual-scintigraphy under postprandial conditions. Residual food was graded by endoscopic examinations. QOL was evaluated using the Gastrointestinal Quality of Life Index, and a stasis- or dumping-related symptom score.

RESULTS

The pouch showed interdigestive contractile activity. Bursts of contractile activity occurred frequently and were long-lasting compared with the migrating motor complex phase III of the control jejunum. The percentage of time of contractile bursts correlated with postprandial pouch emptying (liquid: R(2) = 0.229, P < .03; solid: R(2) = 0.243, P < .02). Patients with little or no residual food had more percentage of time of contractile bursts than those with moderate residual food (P < .01). The percentage of time of contractile bursts was correlated with the Gastrointestinal Quality of Life Index score (R(2) = 0.262, P < .02), stasis-related symptoms (R(2) = 0.279, P < .01), and dumping-related symptoms (R(2) = 0.218, P < .03).

CONCLUSIONS

An interposed jejunum pouch showed bursts of contractile activity that affected postoperative gastrointestinal function and patient QOL.

摘要

背景

空肠袋重建术用于全胃切除术后提供储存功能，但关于袋功能和生活质量（QOL）仍存在争议。在本研究中，结合术后生活质量对袋运动功能进行了研究。

方法

对23例行全胃切除术后空肠袋置入术的患者，在禁食条件下通过测压法检查袋运动功能，并在餐后条件下使用双探头闪烁扫描法进行排空试验。通过内镜检查对残留食物进行分级。使用胃肠道生活质量指数和与淤滞或倾倒相关的症状评分来评估生活质量。

结果

该袋显示出消化间期收缩活动。与对照空肠的移行性运动复合波III期相比，收缩活动爆发频繁且持续时间长。收缩活动爆发的时间百分比与餐后袋排空相关（液体：R² = 0.229，P < 0.03；固体：R² = 0.243，P < 0.02）。残留食物少或无残留食物的患者，其收缩活动爆发的时间百分比高于残留食物中等的患者（P < 0.01）。收缩活动爆发的时间百分比与胃肠道生活质量指数评分（R² = 0.262，P < 0.02）、与淤滞相关的症状（R² = 0.279，P < 0.01）以及与倾倒相关的症状（R² = 0.218，P < 0.03）相关。