Gastric motility after laparoscopically assisted distal gastrectomy, with or without preservation of the pylorus, for early gastric cancer, as assessed by digital dynamic x-ray imaging

Urushihara, Takashi; Sumimoto, Kazuo; Shimokado, Kentaro; Kuroda, Yasuhiro

doi:10.1007/s00464-003-8192-z

Cited by 24 publications

(9 citation statements)

References 13 publications

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“…It is anticipated that preservation of the pyloric sphincter may attenuate rapid gastric emptying and suppress dumping symptomatology, which is one of the most unpleasant sequelae after gastrectomy and substantially affects QOL [15,16]. Thus far, several studies have used various methods to assess the superiority of PPG over DGBI for reducing dumping [17][18][19][20][21][22][23]. We developed the PGSAS-45 as a comprehensive evaluation tool specific to PGS.…”

Section: Discussionmentioning

confidence: 99%

Assessment of postoperative quality of life following pylorus-preserving gastrectomy and Billroth-I distal gastrectomy in gastric cancer patients: results of the nationwide postgastrectomy syndrome assessment study

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Assessment of postoperative quality of life following pylorus-preserving gastrectomy and Billroth-I distal gastrectomy in gastric cancer patients: results of the nationwide postgastrectomy syndrome assessment study

et al. 2015

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“…In subsequent studies, the length of the antral cuff has tended to be longer than that used during the initial period ( Table 1 ). 10 11 14 15 16 17 19 20 21 22 23 24 25 26 27 However, a Japanese group did not identify antral cuff length as a key factor of the PPG technique, reporting comparable postoperative outcomes among a group of patients with an antral cuff length ≤3 cm and a group of patients with an antral cuff length >3 cm. 28 Considering a sufficient distal resection margin of >1 cm for EGC in addition to the length of the antral cuff, the distance from the lesion to the pylorus should be maintained at >4.0 cm.…”

Section: Indications and Surgical Techniquesmentioning

confidence: 99%

Pylorus-Preserving Gastrectomy for Gastric Cancer

Lee

Yang

2016

J Gastric Cancer

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Pylorus-preserving gastrectomy (PPG) is a function-preserving surgery for the treatment of early gastric cancer (EGC), aiming to decrease the complication rate and improve postoperative quality of life. According to the Japanese gastric cancer treatment guidelines, PPG can be performed for cT1N0M0 gastric cancer located in the middle-third of the stomach, at least 4.0 cm away from the pylorus. Although the length of the antral cuff gradually increased, from 1.5 cm during the initial use of the procedure to 3.0 cm currently, its optimal length still remains unclear. Standard procedures for the preservation of pyloric function, infra-pyloric vessels, and hepatic branch of the vagus nerve, make PPG technically more difficult and raise concerns about incomplete lymph node dissection. The short- and long-term oncological and survival outcomes of PPG were comparable to those for distal gastrectomy, but with several advantages such as a lower incidence of dumping syndrome, bile reflux, and gallstone formation, and improved nutritional status. Gastric stasis, a typical complication of PPG, can be effectively treated by balloon dilatation and stent insertion. Robot-assisted pylorus-preserving gastrectomy is feasible for EGC in the middle-third of the stomach in terms of the short-term clinical outcome. However, any benefits over laparoscopy-assisted PPG (LAPPG) from the patient's perspective have not yet been proven. An ongoing Korean multicenter randomized controlled trial (KLASS-04), which compares LAPPG and laparoscopy-assisted distal gastrectomy for EGC in the middle-third of the stomach, may provide more clear evidence about the advantages and oncologic safety of PPG.

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“…Nonetheless, the principal treatment for gastric cancer is still extensive dissection of the lymph node, with primary tumor resection [ 3 4 ]. Patients who undergo distal gastrectomy often have postgastrectomy syndromes such as delayed gastric emptying, dumping syndrome, reduced food intake and reflux esophagitis, which reduce QoL after gastrectomy [ 5 ]. Patients who undergo gastrectomy have poorer QoL than before surgery.…”

Section: Introductionmentioning

confidence: 99%

Clinical features of gastric emptying after distal gastrectomy

et al. 2017

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PurposeGastric emptying may influence the quality of life of patients who undergo distal gastrectomy. Little is known, however, about gastric emptying after distal gastrectomy. The aim of our study was to investigate gastric emptying patterns after distal gastrectomy.MethodsThis gastric-emptying study investigated patients who underwent distal gastrectomy in the 6 months or more before May 2008 to July 2013 at Chungbuk National University Hospital with a study sample of 205 patients. We analyzed patterns of gastric emptying.ResultsDelayed gastric emptying was found in 109 of the 205 patients (53.2%). Food stasis was more frequent in a group with delayed gastric emptying. In multivariate analysis, risk factors for gastroparesis were laparoscopic operation (hazard ratio [HR], 2.731; P = 0.008) and duration of less than 24 months after distal gastrectomy (HR, 2.795; P = 0.001). Delayed gastric emptying tended to decrease with duration of the postoperative period.ConclusionDelayed gastric emptying is common in distal gastrectomy, and is related to laparoscopic operation and duration of the postoperative period. Food stasis was more frequent in a group with delayed gastric emptying.

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Gastric motility after laparoscopically assisted distal gastrectomy, with or without preservation of the pylorus, for early gastric cancer, as assessed by digital dynamic x-ray imaging

Cited by 24 publications

References 13 publications

Assessment of postoperative quality of life following pylorus-preserving gastrectomy and Billroth-I distal gastrectomy in gastric cancer patients: results of the nationwide postgastrectomy syndrome assessment study

Assessment of postoperative quality of life following pylorus-preserving gastrectomy and Billroth-I distal gastrectomy in gastric cancer patients: results of the nationwide postgastrectomy syndrome assessment study

Pylorus-Preserving Gastrectomy for Gastric Cancer

Clinical features of gastric emptying after distal gastrectomy

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