早期胃癌患者内镜下黏膜下剥离术后八周胃排空的变化。
Change in gastric emptying eight weeks after endoscopic submucosal dissection in patients with early gastric cancer.
作者信息
Watanabe Ko, Hikichi Takuto, Sato Masaki, Nakamura Jun, Obara Katsutoshi, Ohira Hiromasa
机构信息
Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Fukushima City, Japan; Department of Endoscopy, Fukushima Medical University Hospital, Fukushima City, Japan.
Department of Endoscopy, Fukushima Medical University Hospital, Fukushima City, Japan.
出版信息
Endosc Int Open. 2016 May;4(5):E597-602. doi: 10.1055/s-0042-105202. Epub 2016 Apr 21.
BACKGROUND
Gastric emptying after endoscopic submucosal dissection (ESD) for early gastric cancer is not clear. The aim of this study was to evaluate changes in gastric emptying from before ESD to 8 weeks after ESD.
METHODS
In total, 54 patients with early gastric cancer were enrolled in this study. A breath test with carbon 13 ((13)C) was conducted before ESD and at 1 and 8 weeks after ESD. The Tlag and T1/2 values were analyzed at each time point. The primary outcomes were the changes in the Tlag and T1/2 values from before ESD to 1 and 8 weeks after ESD. The secondary outcomes were the factors associated with the changes in the Tlag and T1/2 values.
RESULTS
Gastric emptying was delayed at 1 and 8 weeks after ESD compared with before ESD (Tlag P = 0.002, P < 0.001; T1/2 P = 0.005, P = 0.001, respectively). The changes in the Tlag and T1/2 values from before ESD to 1 week after ESD were greater for proximal stomach lesions than for distal stomach lesions (P = 0.028, P < 0.001). Proximal stomach lesions were identified as the significant factor that influenced changes in the Tlag and T1/2 values from before ESD to 1 week after ESD in the multivariate analyses (Tlag P = 0.003, T1/2 P = 0.005).
CONCLUSIONS
ESD induced delayed gastric emptying until 8 weeks after ESD. Proximal stomach lesions were also associated with decreased emptying 1 week after ESD.
背景
早期胃癌内镜黏膜下剥离术（ESD）后的胃排空情况尚不清楚。本研究旨在评估ESD术前至术后8周胃排空的变化。
方法
本研究共纳入54例早期胃癌患者。在ESD术前、术后1周和8周进行碳13（¹³C）呼气试验。分析各时间点的胃排空延迟时间（Tlag）和胃排空半衰期（T1/2）值。主要观察指标为ESD术前至术后1周和8周Tlag和T1/2值的变化。次要观察指标为与Tlag和T1/2值变化相关的因素。
结果
与ESD术前相比，ESD术后1周和8周胃排空延迟（Tlag P = 0.002，P < 0.001；T1/2 P = 0.005，P = 0.001）。ESD术前至术后1周，近端胃病变的Tlag和T1/2值变化大于远端胃病变（P = 0.028，P < 0.001）。多因素分析显示，近端胃病变是影响ESD术前至术后1周Tlag和T1/2值变化的重要因素（Tlag P = 0.003，T1/2 P = 0.005）。
结论
ESD导致胃排空延迟持续至术后8周。近端胃病变也与ESD术后1周胃排空减慢有关。
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