Postoperative Evaluation of Pylorus-Preserving Procedures Compared with Conventional Distal Gastrectomy for Early Gastric Cancer

Abstract

We evaluated postoperative function in 98 patients who underwent surgery for early gastric cancer between 1995 and 1998 to compare the results of pylorus-preserving procedures to those of conventional distal gastrectomy with Billroth I (B-I). The pylorus-preserving procedures included endoscopic mucosal resection (EMR), performed in 12 patients; local resection (Local), performed in 14 patients; segmental resection (Seg), performed in 8 patients; and pylorus-preserving gastrectomy (PPG), performed in 19 patients. B-I was performed in 45 patients. The nutritional status and serum albumin (Alb) levels after PPG, the hemoglobin (Hb) levels after EMR, Local, and PPG, and the present/preoperative body weight ratios after EMR, Local, Seg, and PPG were superior to those after B-I. The time before oral intake was recommenced after EMR and Local, the volume of oral intake tolerated after EMR, Local, Seg, and PPG, and the postoperative hospital stay after EMR were all superior to those after B-I. Moreover, significantly fewer patients suffered reflux symptoms after EMR, Local, and PPG, abdominal fullness after EMR, and early dumping syndrome after EMR, Local, and PPG than after B-I. There was also less evidence of gastritis after EMR, Local, and PPG, and of bile reflux after EMR, Local, and PPG, than after B-I. These findings indicate that pylorus-preserving procedures may result in a better postoperative quality of life for selected patients with early gastric cancer.

Evaluation of a pylorus-preserving gastrectomy for patients preoperatively diagnosed with early gastric cancer located in the middle third of the stomach

“…11,12 However, the frequency of postprandial symptoms after PPG was reduced during the long follow-up periods, and food intake increased in the 2 years following the operation. [12][13][14] Hotta et al 15 reported the nutritional status and serum albumin and hemoglobin levels to be better in PPG patients than in DG patients. Park et al 11 reported that gastritis, bile refl ux, and gallbladder stones were observed in DG patients, but not in PPG patients.…”

Symptom evaluation of long-term postoperative outcomes after pylorus-preserving gastrectomy for early gastric cancer

“…Although several reports have evaluated outcomes following limited resection, the number of cases has been small, with too short an observation period to offer defi nitive evidence of the superiority of these procedures [10][11][12][13][14][15][16][17][18][19].…”

Examination of the Relationship Between Postoperative Quality of Life and Gastric Emptying Function After Pylorus-Preserving Gastrectomy and Distal Gastrectomy

“…8 As a result, several studies have compared postoperative QOL after PPG to that after DGR. 9,10 However, few questionnaire survey studies to date have examined the relationship between residual GEF and postoperative QOL. In the present study, the two abovementioned questionnaire surveys, which are most likely to reflect postoperative QOL, were used for subjective assessment by patients.…”