Department of Esophagogastric Surgery, University Hospital of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
J Surg Res. 2010 Dec;164(2):e229-33. doi: 10.1016/j.jss.2010.08.041. Epub 2010 Sep 22.
Practical questionnaires for evaluating duodenogastric reflux following gastrectomy are currently unavailable. The present study evaluated the usefulness of the frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) questionnaire in the diagnosis of duodenogastric reflux after laparoscopy-assisted distal gastrectomy (LADG), which minimizes the risk of adhesions affecting the gastrointestinal tract.
Subjects in this study comprised 163 patients who had undergone LADG (Billroth-I (B-I), n = 57, Roux-en-Y (R-Y), n = 106). All subjects underwent endoscopy at least 6 mo postoperatively. The FSSG questionnaire was administered a few weeks after endoscopy, and FSSG scores were compared with endoscopic findings.
In the R-Y group, FSSG scores were significantly higher in subjects with remnant gastritis than in those without (P = 0.002), and a significant correlation was seen between FSSG scores and bile reflux (P = 0.046). In the B-I group, FSSG scores were significantly higher in subjects with reflux esophagitis than in those without (P = 0.01), but degree of remnant gastritis and residual food did not correlate significantly with FSSG scores. With a cut-off FSSG score of six points, sensitivity and specificity for predicting remnant gastritis in R-Y reconstruction were 71% and 76%, respectively.
The FSSG questionnaire is a viable and less invasive alternative to other modalities for evaluating duodenogastric reflux in R-Y reconstruction, but is unsuitable for B-I reconstruction after LADG.
目前尚无用于评估胃切除术后十二指肠胃反流的实用问卷。本研究评估了频率量表在腹腔镜辅助远端胃切除术后（LADG）诊断十二指肠胃反流中的作用，该量表可最大程度减少影响胃肠道的粘连风险。
本研究纳入了 163 例接受 LADG（Billroth-I（B-I），n = 57，Roux-en-Y（R-Y），n = 106）的患者。所有患者术后至少 6 个月进行内镜检查。内镜检查后数周进行 FSSG 问卷评估，并将 FSSG 评分与内镜检查结果进行比较。
在 R-Y 组中，残胃炎患者的 FSSG 评分明显高于无残胃炎患者（P = 0.002），FSSG 评分与胆汁反流之间存在显著相关性（P = 0.046）。在 B-I 组中，反流性食管炎患者的 FSSG 评分明显高于无反流性食管炎患者（P = 0.01），但残胃炎和残食程度与 FSSG 评分无显著相关性。以 FSSG 评分 6 分为截断值，R-Y 重建中预测残胃炎的敏感性和特异性分别为 71%和 76%。
FSSG 问卷是一种可行的、微创的替代方法，可用于评估 R-Y 重建中的十二指肠胃反流，而不适合用于 LADG 后的 B-I 重建。
