First Department of Surgery, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 4093898, Japan.
Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 6028566, Japan.
Surg Today. 2024 Sep;54(9):1104-1111. doi: 10.1007/s00595-024-02845-7. Epub 2024 Apr 23.
In recent years, clinicians have focused on the importance of preventing hypoglycemia. We evaluated the impact of different reconstruction procedures after proximal gastrectomy on glycemic variability in non-diabetic patients with gastric cancer.
This prospective observational study was conducted between April 2020 and March 2023. Flash continuous glucose-monitoring, a novel method for assessing glycemic control, was used to evaluate the glycemic profiles after gastrectomy. A flash continuous glucose-monitoring sensor was placed subcutaneously at the time of discharge, and glucose trends were evaluated for 2 weeks.
The anastomotic methods for proximal gastrectomy were esophagogastrostomy in 10 patients and double-tract reconstruction in 10 patients. The time below this range (glucose levels < 70 mg/dL) was significantly higher in the double-tract reconstruction group than in the esophagogastrostomy group (p = 0.049). A higher nocturnal time below this range was significantly correlated with an older age and double-tract reconstruction (p = 0.025 and p = 0.025, respectively).
These findings provide new insights into reconstruction methods after proximal gastrectomy by assessing postoperative hypoglycemia in non-diabetic patients with gastric cancer.
近年来，临床医生越来越重视预防低血糖的重要性。我们评估了近端胃切除术后不同重建方法对非糖尿病胃癌患者血糖变异性的影响。
这是一项前瞻性观察研究，于 2020 年 4 月至 2023 年 3 月进行。采用闪光连续血糖监测这一新方法评估胃切除术后的血糖谱。在出院时将闪光连续血糖监测传感器皮下放置，并评估 2 周的血糖趋势。
近端胃切除术的吻合方法为食管胃吻合术 10 例，双道重建术 10 例。双道重建组血糖水平低于此范围（<70mg/dL）的时间明显长于食管胃吻合术组（p=0.049）。夜间血糖水平低于此范围的时间较长与年龄较大和双道重建明显相关（p=0.025 和 p=0.025）。
这些发现通过评估非糖尿病胃癌患者术后低血糖症，为评估近端胃切除术后的重建方法提供了新的见解。
