Takahashi Tsuyoshi, Endo Shunji, Nakajima Kiyokazu, Souma Yoshihito, Nishida Toshirou
Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
World J Surg. 2009 Feb;33(2):296-302. doi: 10.1007/s00268-008-9854-8.
Distal gastrectomy (DG) and pylorus-preserving gastrectomy (PPG) have been employed for gastric cancer, with PPG having been reported to be superior to DG in regard to postoperative quality of life. Some patients with these operations still suffer from gastric stasis, however. In this study, we aimed to examine the clinical effects of rikkunshito on patients who were to undergo PPG.
A total of 11 patients who were scheduled to undergo PPG for early gastric cancer at the Osaka University Hospital were enrolled. The patients were randomly assigned to the crossover study with and without rikkunshito 7.5 g/day. Questionnaires and emptying tests using (111)In-labeled liquid scintigraphy and (99m)Tc-labeled solid scintigraphy were performed at the end of each treatment period.
Stasis-related symptoms were significantly reduced during rikkunshito treatment (p = 0.043). The emptying test showed that rikkunshito improved emptying of solid meals (p = 0.0003) from the remnant stomach but did not accelerate gastric empting of liquid meals.
Rikkunshito improved gastric emptying and ameliorated postoperative symptoms of patients who had undergone a PPG.
远端胃切除术(DG)和保留幽门胃切除术(PPG)已用于治疗胃癌,据报道PPG在术后生活质量方面优于DG。然而,接受这些手术的一些患者仍存在胃潴留问题。在本研究中,我们旨在研究六君子汤对拟行PPG患者的临床疗效。
大阪大学医院共有11例计划接受早期胃癌PPG手术的患者入组。患者被随机分配至接受或不接受每日7.5 g六君子汤的交叉研究。在每个治疗期结束时进行问卷调查,并使用(111)铟标记液体闪烁扫描和(99m)锝标记固体闪烁扫描进行排空试验。
在六君子汤治疗期间,与潴留相关的症状显著减轻(p = 0.043)。排空试验表明,六君子汤改善了残胃固体食物的排空(p = 0.0003),但未加速液体食物的胃排空。
六君子汤改善了接受PPG手术患者的胃排空并减轻了术后症状。