No abstract

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.

Objective: This study measured skeletal muscle mass (SMM) in postoperative gastric cancer patients, to compare SMM to traditional postoperative assessment based on anthropomorphic measures and blood tests, and evaluated the methods of SMM measurement. Summary of Background Data: SMM, which helps to maintain general health and quality of life, is very important. Measurement of total psoas major muscle area (TPA) by computed tomography imaging has recently been reported to be a useful index of SMM. Methods: This retrospective study included 92 patients who underwent distal gastrectomy for gastric cancer. SMM was measured by TPA index (computed tomography measurement of TPA / square of height) and bioelectric impedance analysis (BIA). Patients were divided into short-term (,3 years) and long-term (3 years) postoperative follow-up groups. SMM and traditional postoperative assessment, as well as body mass index, albumin, hemoglobin, and total cholesterol, were compared between the 2 groups. The correlations between the TPA index and the SMM of BIA and traditional postoperative assessment were examined by simple regression analysis. Results: The SMM of BIA was 24.1 6 4.1 kg in the short-term and 22.0 6 4.7 kg in the longterm group (P ¼ 0.02), and TPA index was 783.4 6 166.9 mm 2 /m 2 in the short-term and 687.5 6 167.2 mm 2 /m 2 in the long-term group (P ¼ 0.01), whereas there were no significant differences in traditional postoperative assessment. On simple regression analysis, TPA index showed the strongest correlation with SMM of BIA (R ¼ 0.56).

The TRC assay method using lymph node washings is a rapid, simple genetic diagnosis with greater sensitivity than conventional diagnosis by H&E staining of permanent specimens, and enables conservation of lymph nodes in toto as permanent specimens. This TRC method would enable rapid diagnosis even in town hospitals where no pathologist is ordinarily stationed, and is considered to contribute to the clinical application of the sentinel node theory of gastric cancer treatment.

The objective of this study was to compare postoperative quality of life (QOL) of patients with early cancer of the body of the stomach who were treated with pylorus-preserving gastrectomy (PPG) and those treated with distal gastrectomy (DGR), and to evaluate the relationship between postoperative QOL and gastric emptying function (GEF). Patients with early cancer of the body of the stomach are often treated with PPG to preserve gastric function, and their QOL appears to be better after PPG than after DGR. Differences in postoperative GEF are thought to be a factor, but the relationship between GEF and postoperative QOL has not been well investigated. A total of 60 patients [23 PPG and 37 DGR (Billroth I)] completed QOL surveys [SF-36, Gastrointestinal Symptom Rating Scale (GSRS)] and underwent 13 C-breath tests to evaluate GEF in two groups ( 12 months postoperatively and .12 months postoperatively). The time until the percentage of breath 13 CO 2 reaches a peak during the 13 C-breath test (Tmax), which is an index of gastric emptying velocity, was evaluated. For the SF-36, there were no significant differences between the two procedures. For GSRS, a trend toward better scores was seen after PPG; abdominal pain and total scores at .12 months postoperatively were significantly better with PPG. Tmax was significantly longer for PPG patients. For each procedure, symptoms significantly worsened when Tmax was ,21 minutes at .12 months after surgery. Although postoperative GEF evaluated by 13 C-breath tests did not affect overall QOL measured by the SF-36, it did affect disease-specific QOL measured by GSRS.