Quantitative evaluation of reconstruction methods after gastrectomy using a new type of examination: digestion and absorption test with stable isotope 13 C-labeled lipid compound

Takase, Makoto; Sumiyama, Yoshinobu; Nagao, Jirō

doi:10.1007/s10120-003-0238-3

Cited by 38 publications

(31 citation statements)

References 7 publications

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“…Hyperglycemia following intake of 75-g glucose frequently occurs in patients undergoing pancreatoduodenectomy, because pancreatoduodenectomy includes reconstruction of the alimentary tract or gastrectomy, and these procedures allow carbohydrate influx directly into the small intestine. Several investigators reported that patients with subtotal gastrectomy frequently developed hyperglycemia after an oral glucose tolerance test [27,28]. In contrast, serum HbA 1c levels are usually used as an indicator of glycemic control and do not require glucose ingestion.…”

Section: Discussionmentioning

confidence: 99%

Long‐term pancreatic endocrine function following pancreatoduodenectomy with pancreaticogastrostomy

Murakami

Uemura

Hayashidani

et al. 2008

Journal of Surgical Oncology

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Section: Discussionmentioning

confidence: 99%

Long‐term pancreatic endocrine function following pancreatoduodenectomy with pancreaticogastrostomy

Murakami

Uemura

Hayashidani

et al. 2008

Journal of Surgical Oncology

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“…It is well known that moderate malnutrition is often associated with gastric cancer surgery [16] , and that esophagogastrostomy reconstruction is more favorable to the natural food passage of the duodenum than esophagojejunostomy. It has been shown that independent prognostic factors such as ensuring radical cure, maintaining food passage in the duodenum, and less excision of the stomach, are very important for postoperative QOL [17,18] . A high incidence of reflux symptoms after simple esophagogastrostomy has prompted the development of several novel reconstructions to prevent reflux [12,[19][20][21] .…”

Section: Discussionmentioning

confidence: 99%

Improved quality of life in patients with gastric cancer after esophagogastrostomy reconstruction

Zhang¹,

Sun²,

Xu³

et al. 2009

WJG

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AIM:To compare postoperative quality of life (QOL) in patients with gastric cancer treated by esophagogastrostomy reconstruction after proximal gastrectomy.METHODS: QOL assessments that included functional outcomes (a 24-item survey about treatmentspecific symptoms) and health perception (Spitzer QOL Index) were performed in 149 patients with gastric cancer in the upper third of the stomach, who had received proximal gastrectomy with additional esophagogastrostomy. RESULTS:Fifty-four patients underwent reconstruction by esophagogastric anterior wall end-to-side anastomosis combined with pyloroplasty (EA group); 45 patients had reconstruction by esophagogastric posterior wall end-to-side anastomosis (EP group); and 50 patients had reconstruction by esophagogastric end-to-end anastomosis (EE group). The EA group showed the best postoperative QOL, such as recovery of body weight, less discomfort after meals, and less heart burn or belching at 6 and 24 mo postoperatively. However, the survival rates, surgical results and Spitzer QOL index were similar among the three groups. CONCLUSION:Postoperative QOL was better in the EA than EP or EE group. To improve QOL after proximal gastrectomy for upper third gastric cancer, the EA procedure using a stapler is safe and feasible for esophagogastrostomy.

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“…In this study, we performed the 13 C-labeled mixed triglyceride breath test to assess digestive and absorptive ability after subtotal gastrectomy. 13 C is a stable isotope, and is reported to represent 1.1% of existing carbon atoms in nature [14]. As it is not radioactive, and dose not have any possibility of explosion or contamination, it can be safely used for children and pregnant women.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the reduced postprandial motor response suggests a hormonal mediator abnormality [23]. Comparison of these reconstructive routes is considered a feasible method for assessment of nutrition in patients who underwent different gastric reconstructive procedures following gastrectomy [14]. …”

Section: Discussionmentioning

confidence: 99%

Analysis of Fat Digestive and Absorptive Function after Subtotal Gastrectomy by a <sup>13</sup>C-Labeled Mixed Triglyceride Breath Test

Nakamura

Murakami²,

Morifuji³

et al. 2009

Digestion

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Background/Aim: In the choice of reconstructions, digestive and absorptive disturbances, resulting in weight loss after subtotal gastrectomy, remain a problem. The aim of this study was to compare fat absorptive function after Billroth I (B-I) and Roux-en-Y (RY) reconstructions after subtotal gastrectomy for gastric cancer. Methods: A ¹³C-labeled mixed triglyceride breath test was performed in 31 patients after subtotal gastrectomy and in 15 healthy volunteers to assess fat digestive and absorptive function. Seventeen B-I reconstructions and 14 RY reconstructions were performed after subtotal gastrectomy. Fat digestive and absorptive function was determined by percent ¹³CO₂ cumulative dose at 7 h. Relationship between fat absorptive function and perioperative factors were analyzed. Results: Gender distribution, mean age, pathological staging, level of lymph node dissection, preservative procedure of the vagus nerve and mean follow-up period in the two surgical groups did not differ significantly. Only the type of reconstruction (p = 0.024) was associated with differences in fat digestive and absorptive function by univariate analysis: B-I reconstruction was superior to RY reconstruction. Conclusions: Fat digestive and absorptive function after B-I reconstruction was superior to that after RY reconstruction, probably because the B-I reconstruction was the procedure that permitted food passage through the duodenum.

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Quantitative evaluation of reconstruction methods after gastrectomy using a new type of examination: digestion and absorption test with stable isotope 13 C-labeled lipid compound

Abstract: absorption of medium-chain triglycerides, and the patients also showed a better physiological state.

Cited by 38 publications

References 7 publications

Long‐term pancreatic endocrine function following pancreatoduodenectomy with pancreaticogastrostomy

Long‐term pancreatic endocrine function following pancreatoduodenectomy with pancreaticogastrostomy

Improved quality of life in patients with gastric cancer after esophagogastrostomy reconstruction

Analysis of Fat Digestive and Absorptive Function after Subtotal Gastrectomy by a <sup>13</sup>C-Labeled Mixed Triglyceride Breath Test

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