Rivera Isabel, Ochoa-Martínez Carmen Ibeth, Hermosillo-Sandoval José Manuel, Morales-Amezcua Juan Manuel, Fuentes-Orozco Clotilde, González-Ojeda Alejandro
Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico.
Cir Cir. 2007 Nov-Dec;75(6):429-34.
We undertook this study to establish the incidence of dumping syndrome after partial or total gastric resection and its association with patient's preoperative nutritional status as well as the clinical behavior with dietary management during a short-term follow-up period.
This was a prospective study of consecutive patients >30 years of age and who were submitted to gastrectomy for gastric cancer or complicated ulceropeptic disease during a 48-month period in a highly specialized hospital.
A total of 42 patients were evaluated with a slight female predominance (n = 22, 52.4%). Twenty-nine cases (69%) had subtotal gastrectomy and 13 (31%) had a total gastrectomy. Patients had a medium age of 54.38 +/- 7.56 vs. 66 +/- 13.99 years, respectively (p = 0.034). Reconstruction techniques were Roux-en-Y gastrojejunostomy in 70% and Roux-en-Y esophagojejunostomy in 28.5%. We found dumping syndrome in 45% of the cases associated with acute or chronic undernutrition (p = 0.003). Fifty-three percent of the patients with dumping syndrome improved with adequate dietetic manipulation during a follow-up period of 211 days.
Although the majority of reconstructions were performed with dysfunctionalized small bowel segments, the incidence of dumping syndrome was 45%. Patient's preoperative nutritional status influenced the presence of clinical manifestations. Adequate dietary management reduced, in 53% of the patients, the presence of dumping symptoms during a short-term follow-up period.
我们开展这项研究是为了确定部分或全胃切除术后倾倒综合征的发生率，及其与患者术前营养状况的关联，以及在短期随访期间饮食管理的临床效果。
这是一项对年龄大于30岁、在一家高度专业化医院的48个月期间因胃癌或复杂性溃疡病接受胃切除术的连续患者进行的前瞻性研究。
共评估了42例患者，女性略占优势（n = 22，52.4%）。29例（69%）接受了胃大部切除术，13例（31%）接受了全胃切除术。患者的平均年龄分别为54.38±7.56岁和66±13.99岁（p = 0.034）。重建技术为70%的Roux-en-Y胃空肠吻合术和28.5%的Roux-en-Y食管空肠吻合术。我们发现45%的病例出现倾倒综合征，且与急性或慢性营养不良相关（p = 0.003）。53%的倾倒综合征患者在211天的随访期内通过适当的饮食调整得到改善。
尽管大多数重建手术是在功能失调的小肠段上进行的，但倾倒综合征的发生率为45%。患者术前的营养状况影响临床表现的出现。在短期随访期内，适当的饮食管理使53%的患者倾倒症状得到缓解。
