Second Department of Surgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
World J Surg. 2012 Feb;36(2):373-8. doi: 10.1007/s00268-011-1379-x.
Attention has recently focused on decreased quality of life (QOL) that occurs in postgastrectomy patients. We verified how gastric emptying function affected QOL.
Subjects were 72 consecutive patients after gastrectomy for cancer, including 25 after distal gastrectomy (DG), 18 after proximal gastrectomy (PG), 16 after pylorus-preserving gastrectomy (PpG), and 13 after total gastrectomy (TG). Using the (13)C breath test method, (13)CO(2) levels in breath were measured over 2 h, and T (max) was determined. Questionnaires (Japanese versions of the Short-Form 36 [SF-36] and Gastrointestinal Symptom Rating Scale [GSRS]) were used to analyze QOL and correlations between questionnaire results and T (max).
Mean T (max) (min) for each procedure was 15.4 for DG, 21.1 for PG, 41.3 for PpG, and 10.4 for TG. T (max) differed between procedures, but not between survey periods. SF-36 was not correlated with T (max), whereas GSRS showed a difference in diarrhea and total score between procedures, but not between survey periods. In addition, GSRS correlated with T (max) for abdominal pain, indigestion, and total score. The total scores showed a significant symptom aggregation in patients with T (max) less than 21 min.
Gastrointestinal symptoms in postgastrectomy patients were associated with the function of the remaining stomach. The (13)C breath test is useful for objectively assessing such symptoms.
近期人们关注到胃切除术后患者生活质量(QOL)下降的问题。我们验证了胃排空功能如何影响 QOL。
研究对象为 72 例因胃癌行胃切除术的患者,包括远端胃切除术(DG)25 例、近端胃切除术(PG)18 例、保留幽门胃切除术(PpG)16 例和全胃切除术(TG)13 例。采用 13C 呼气试验法,在 2 小时内测量呼气中 13CO2 水平,确定 T(max)。使用(短式)36 健康调查量表(SF-36)和胃肠道症状评定量表(GSRS)的日本版问卷调查评估 QOL,并分析问卷结果与 T(max)的相关性。
DG、PG、PpG 和 TG 的 T(max)(min)平均值分别为 15.4、21.1、41.3 和 10.4。不同手术方法的 T(max)存在差异,但不同调查时间点无差异。SF-36 与 T(max)无相关性,而 GSRS 在腹泻和总分方面显示出不同手术方法之间的差异,但不同调查时间点无差异。此外,GSRS 与腹痛、消化不良和总分方面的 T(max)呈正相关。T(max)小于 21 分钟的患者总评分显示出明显的症状聚集。
胃切除术后患者的胃肠道症状与残胃功能有关。13C 呼气试验有助于客观评估此类症状。