Tanaka Tetsuya, Takayama Tomoyoshi, Matsumoto Sohei, Wakatsuki Kohei, Enomoto Koji, Migita Kazuhiro, Ito Masahiro, Nakajima Yoshiyuki
Department of Surgery, Nara Medical University, Nara, Japan.
Hepatogastroenterology. 2013 Jan-Feb;60(121):200-6. doi: 10.5754/hge12500.
BACKGROUND/AIMS: Pylorus-preserving nearly-total gastrectomy (PPNTG) for gastric cancer is based on the principle that the operation prevents the rapid gastric emptying and reflux that occurs after traditional gastrectomy. In this study, we evaluate the postoperative functional status of patients undergoing PPNTG in comparison with total gastrectomy with Roux-en-Y reconstruction (TG-RY).
Ninety-six patients with gastric cancer underwent PPNTG or TG-RY at Nara Medical University Hospital. Short-term outcomes were analyzed retrospectively through medical records from hospitalization. Long-term outcomes were evaluated via questionnaires concerning postoperative function.
Of the 96 cases, 32 underwent PPNTG and 64 underwent TG-RY. There were no significant differences in operation time, intraoperative blood loss, postoperative complications, or length of stay. Forty-eight patients responded to the questionnaire (PPNTG: 18, TG-RY: 30). The incidence of general malaise, headaches, chest pain, heartburn and cold sweats was significantly lower in the PPNTG group. Nutritional assessment revealed no differences between the groups.
For gastric cancer of the proximal stomach, PPNTG is a safe alternative to TG-RY, and improves patients' long-term quality of life.
背景/目的：保留幽门的近全胃切除术（PPNTG）治疗胃癌基于这样的原则，即该手术可防止传统胃切除术后出现的胃排空过快和反流。在本研究中，我们评估接受PPNTG的患者与接受Roux-en-Y重建的全胃切除术（TG-RY）患者术后的功能状态。
96例胃癌患者在奈良医科大学医院接受了PPNTG或TG-RY手术。通过住院病历对短期结局进行回顾性分析。通过关于术后功能的问卷评估长期结局。
96例患者中，32例行PPNTG，64例行TG-RY。手术时间、术中出血量、术后并发症或住院时间无显著差异。48例患者回复了问卷（PPNTG组：18例，TG-RY组：30例）。PPNTG组全身不适、头痛、胸痛、烧心和冷汗的发生率显著较低。营养评估显示两组之间无差异。
对于胃近端癌，PPNTG是TG-RY的一种安全替代方法，可改善患者的长期生活质量。
