早期胃癌行保留幽门胃切除术后5年及以上患者的十二指肠消化间期移行性运动复合波

Duodenal interdigestive migrating motor complex in patients 5 years or more after pylorus-preserving gastrectomy for early gastric cancer.

作者信息

Tomita Ryouichi, Koshinaga Tugumichi, Ikeda Taro, Fujisaki Shigeru, Tanjoh Katsuhisa

机构信息

Department of Surgery, Nippon Dental University School of Dentistry at Tokyo, 2-3-16 Fujimi, Chiyoda-ku, Tokyo, 102-8158, Japan.

出版信息

World J Surg. 2006 Aug;30(8):1459-67. doi: 10.1007/s00268-005-0676-7.

DOI:10.1007/s00268-005-0676-7

PMID:16850147

Abstract

BACKGROUND

We investigated the relationship between interdigestive migrating motor complex, phase III (IMMC-pIII) and postoperative quality of life (QOL) in pylorus-preserving gastrectomy (PPG) patients.

MATERIALS AND METHODS

A total of 40 patients (26 men and 14 women; average age 59.4 years) 5 to 7.5 years after PPG for early gastric cancer (Billroth I) (average 6 years and 3 months) were divided into two groups according to the occurrence of IMMC-pIII from the duodenum, and their postoperative quality of life (QOL) was compared.

RESULTS

As for appetite, "No change compared with before operation" was significantly more frequent in the IMMC-pIII positive group compared with the negative group (P=0.0002). Food consumption per meal compared with normal; "80% or more" was significantly more frequent in the IMMC-pIII positive group than the negative group (P=0.0002). Body weight loss during 5 years after surgery; "6 kg or more" was significantly more frequent in the IMMC-pIII negative group than the positive group (P=0.0002). Early dumping symptoms did not occur in any patients of either group. Reflux esophagitis and nausea; no patients in the IMMC-pIII positive group experienced these symptoms, which was significantly different from the negative group (P=0.0018). Abdominal pain occurred but was significantly less frequent in the IMMC-pIII positive group than in the negative group (P=0.0023). Epigastric fullness occurred but was less frequent in the IMMC-pIII positive group compared with the negative group (P<0.0001). Gastric stasis of the remnant stomach was significantly more frequent in the IMMC-pIII negative group than in the positive group (P<0.0001). Gholelithiasis was significantly more frequent in the IMMC-pIII negative group than in the positive group (P=0.0119).

CONCLUSIONS

These results showed more satisfactory QOL in the IMMC-PIII positive group than in the negative group.

摘要

背景

我们研究了保留幽门胃切除术（PPG）患者的消化间期移行性复合运动Ⅲ期（IMMC-pIII）与术后生活质量（QOL）之间的关系。

材料与方法

对40例因早期胃癌行PPG（毕Ⅰ式）术后5至7.5年（平均6年零3个月）的患者（26例男性和14例女性；平均年龄59.4岁），根据十二指肠IMMC-pIII的发生情况分为两组，并比较其术后生活质量（QOL）。

结果

在食欲方面，IMMC-pIII阳性组“与术前相比无变化”的情况明显多于阴性组（P = 0.0002）。每餐食物摄入量与正常相比；“80%或更多”在IMMC-pIII阳性组明显多于阴性组（P = 0.0002）。术后5年体重减轻；“6公斤或更多”在IMMC-pIII阴性组明显多于阳性组（P = 0.0002）。两组患者均未出现早期倾倒症状。反流性食管炎和恶心；IMMC-pIII阳性组无患者出现这些症状，与阴性组有显著差异（P = 0.0018）。腹痛有发生，但IMMC-pIII阳性组明显少于阴性组（P = 0.0023）。上腹部饱胀有发生，但IMMC-pIII阳性组比阴性组少见（P<0.0001）。残胃胃潴留在IMMC-pIII阴性组明显多于阳性组（P<0.0001）。胆石症在IMMC-pIII阴性组明显多于阳性组（P = 0.0119）。