Relationship between Gastric Stasis in the Remnant Stomach and Interdigestive Migrating Complex in Patients after Pylorus-Preserving Gastrectomy for Gastric Cancer — Oak Academic Publishing
Research ArticleOpen AccessGoogle Scholar indexed
Relationship between Gastric Stasis in the Remnant Stomach and Interdigestive Migrating Complex in Patients after Pylorus-Preserving Gastrectomy for Gastric Cancer
Department of Surgery, School of Life Dentistry, Nippon Dental University, Tokyo, Japan
,
First Department of Surgery, Nihon University School of Medicine, Tokyo, Japan
,
First Department of Surgery, Nihon University School of Medicine, Tokyo, Japan
,
First Department of Surgery, Nihon University School of Medicine, Tokyo, Japan
,
First Department of Surgery, Nihon University School of Medicine, Tokyo, Japan
1 Department of Surgery, School of Life Dentistry, Nippon Dental University, Tokyo, Japan
2 First Department of Surgery, Nihon University School of Medicine, Tokyo, Japan
3 First Department of Surgery, Nihon University School of Medicine, Tokyo, Japan
4 First Department of Surgery, Nihon University School of Medicine, Tokyo, Japan
5 First Department of Surgery, Nihon University School of Medicine, Tokyo, Japan
Objectives: The demerit of pylorus-preserving gastrectomy (PPG) is gastric stasis in the remnant stomach (GSRS). We investigated the relationship between postgastrectomy disorder (PGD), especially GSRS, and interdigestive migrating complex (IMC) in PPG patients. Background: The cause of GSRS is still unknown. Therefore, we studied relationship between GSRS and IMC. Methods: 24 PPG patients (16 men and 8 women; mean, 61.2 years) were divided into groups A (12 patients without GSRS) and B (12 patients with GSRS). The relationship between GSRS and IMC was studied. Results: Length of the antral cuff (LAC) was significantly longer in group A than group B ( P < 0.0001). IMC and appetite were significantly more common in group A than in group B ( P = 0.0465, P = 0.0186, respectively). Postprandial abdominal fullness (PAF) was significantly more common in group B than in group A ( P = 0.0061). Reflux esophagitis (RE) and body weight loss were found in group B more than in group A. Dumping syndrome was not found in either group. Endoscopic gastritis was found significantly more in group B than in group A (P = 0.0047). Conclusions: In PPG patients with a short LAC, GSRS may occur by the decrease of IMC occurrence.
KeywordsGastric Stasis in the Remnant StomachInterdigestive Migrating ComplexPylorus-Preserving GastrectomyGastric Cancer
Imada, T., Rino, Y., Takahashi, M., Hatori, S., Tanaka, J., Shiozawa, M., et al. (1998) Gastric Emptying after Pylorus-Preserving Gastrectomy in Comparison with Conventional Subtotal Gastrectomy for Early Gastric Carcinoma. Surgery Today, 28, 135-138. https://doi.org/10.1007/s005950050094
Matsuki, A., Nashimoto, A., Yabusaki, H. and Nakagawa, S. (2012) Long-Term Clinical Outcome and Survival after Pylorus-Preserving Gastrectomy. Hepatogastroenterology, 59, 2012-2015. https://doi.org/10.5754/hge11785
Shibata, C., Saijo, F., Kakyo, M., Kinouchi, M., Tanaka, N., Sasaki, I., et al. (2012) Current Status of Pylorus-Preserving Gastrectomy for Treatment of Gastric Cancer: A Questionnaire Survey and Review of Literatures. World Journal of Surgery, 36, 858-863. https://doi.org/10.1007/s00268-012-1491-6
Hiki, N., Nunobe, S., Kubota, T. and Jiang, X. (2013) Function-Preserving Gastrectomy for Early Gastric Cancer. Annals of Surgical Oncology, 20, 2683-2692. https://doi.org/10.1245/s10434-013-2931-8
Park, D.J., Lee, H.J., Jung, H.C., Kim, W.H., Lee, K.U. and Yang, H.K. (2008) Clinical Outcome of Pylorus-Preserving Gastrectomy in Gastric Cancer in Comparison with Conventional Distal Gastrectomy with Billroth I anastomosis. World Journal of Surgery, 32, 1029-1036. https://doi.org/10.1007/s00268-007-9441-4
Takahashi, T., Endo, S., Nakajima, K., Souma, Y. and Nishida, T. (2009) Effect of Rikkunshito: A Chinese Herbal Medicine, on Stasis in Patients after Pylorus-Preserving Gastrectomy. World Journal of Surgery, 33, 296-302. https://doi.org/10.1007/s00268-008-9854-8
Gielkens, H.A., Nieuwenhuizen, A., Biemond, I., Lamers, C.B. and Masclee, A.A. (1998) Interdigestive Antrodudenal Motility and Acid Secretion. Alimentary Pharmacology Therapeutics, 12, 27-33. https://doi.org/10.1046/j.1365-2036.1998.00267.x
Penning, C., Gielkens, H.A., Hemelaar, M., Lamers, C.B. and Masclee, A.A. (2001) Reproduciblity of Antroduodenal Motility during Prolonged Ambulatory Recording. Neurogastroenterology & Motility, 13, 133-141. https://doi.org/10.1046/j.1365-2982.2001.00252.x
Luiking, Y.C., Akkermans, L.M., Peeters, T.L., Cnossen, P.J., Nieuwenhuijs, V.B. and Vanberge-Henegouwen, G.P. (2002) Effects of Motilin on Human Interdigestive Gastrointestinal and Gallbladder Motility, and Involvement of 5HT3 Receptors. Neurogastroenterology & Motility, 14, 151-159. https://doi.org/10.1046/j.1365-2982.2002.00314.x
Tomita, R. (2009) Relationship between Interdigestive Migrating Motor Complex and Gut Hormones in Human. Hepatogastroenterology, 56, 714-717.
Fukuhara, H., Imamaura, H. and Kodera, K. (2002) The Role of Surgery in the Current Treatment of Gastric Carcinoma. Gastric Cancer, 5, 13-16. https://doi.org/10.1007/s10120-002-0207-2
Ikeda, Y., Saku, M., Kawanaka, H., Nonaka, M., Yoshida, K., Maehara, Y., et al. (2004) Prophylactic Lymph Node Dissection for Early Gastric Cancer Invading Submucosa. Hepatogastroenterology, 51, 887-890.
Katsumi, M., Kono, N. and Okamura, S. (1983) Postoperative Functioning of the Remaining Stomach after Pyloric Sphincter Preserving Gastrectomy. International Surgery, 68, 65-71.
Kodama, M., Koyama, K., Chida, T., Arakawa, A. and Tur, G. (1995) Early Postoperative Evaluation of Pylorus-Preserving Gastrectomy for Gastric Cancer. World Journal of Surgery, 19, 456-461. https://doi.org/10.1007/BF00299190
Tomita, R., Fujisaki, S., Tanjoh, K. and Fukuzawa, M. (2000) Relationship between Gastroduodenal Interdigestive Migrating Motor Complex and Quality of Life in Patients with Distal Subtotal Gastrectomy for Early Gastric Cancer. International Surgery, 85, 118-123.
Nakane, Y., Michiura, T., Inoue, K., Sato, M., Nakai, K. and Yamamichi, K. (2002) Length of the Antral Segment in Pylorus-Preserving Gastrectomy. British Journal of Surgery, 89, 220-224. https://doi.org/10.1046/j.1365-2168.2002.01984.x
Tomita, R., Sakurai, K. and Fujisaki, S. (2017) Relationships between Length of the Antral Cuff and Postgastrectomy Disorders and Gastric Empting Function in Patients after Pylorus-Preserving Gastrectomy for Early Gastric Cancer. Journal of Cancer Therapy, 8, 867-879. https://doi.org/10.4236/jct.2017.810076
Kubo, M., Sasako, M., Gotoda, T., Ono, H., Fujishiro, M., Saito, D., et al. (2002) Endoscopic Evaluation of the Remnant Stomach after Gastrectomy: Proposal for a New Classification. Gastric Cancer, 5, 83-89. https://doi.org/10.1007/s101200200014
Nagano, H., Ohyama, S., Sakamoto, Y., Ohta, K., Yamaguchi, T., Muto, T., et al. (2004) The Endoscopic Evaluation of Gastritis, Gastric Remnant Residue, and the Incidence of Secondary Cancer after Pylorus-Preserving and Transverse Gastrectomies. Gastric Cancer, 7, 54-59. https://doi.org/10.1007/s10120-004-0269-4
Yamaguchi, T., Ichikawa, D., Kurioka, H., Ikoma, H., Koike, H., Otsuji, E., et al. (2004) Postoperative Clinical Evaluation of Following Pylorus-Preserving Gastrectomy. Hepatomastroenterology, 51, 883-886.
Morita, S., Sasako, M., Saka, M., Fukagawa, T., Sano, T. and Katai, H. (2010) Correlation between the Length of the Pyloric Cuff and Postoperative Evaluation after Pylorus-Preserving Gastrectomy. Gastric Cancer, 13, 109-116. https://doi.org/10.1007/s10120-010-0549-0
Tack, J., Depoortere, I., Bisschops, R., Delporte, C., Coulie, B., Meulemans, A., et al. (2006) Influence of Ghrelin on Interdigestive Gastrointestinal Motility in Humans. Gut, 55, 327-333. https://doi.org/10.1136/gut.2004.060426
Haans, J.J. and Masclee, A.A. (2006) Intragastric Acidification Inhibits Motilin-Induced Phase III Activity in Humans. Neurogastroenterology & Motility, 18, 637-646. https://doi.org/10.1111/j.1365-2982.2006.00797.x
Takahashi, T. (2012) Mechanism of Interdigestive Migrating Motor Complex. Journal of Neurogastroenterology and Motility, 18, 246-257. https://doi.org/10.5056/jnm.2012.18.3.246
Tomita, R., Takizawa, H. and Tanjoh, K. (1998) Physiological Effects of Cisapride on Gastric Emptying after Pylorus-Preserving Gastrectomy for Early Gastric Cancer. World Journal of Surgery, 22, 35-41. https://doi.org/10.1007/s002689900346
Tomita, R., Sakurai, K., Fujisaki, S., Inoue, M., Sugito, K. and Park, E. (2015) Interdigestive Motor Complex and Postoperative Quality of Life in Patients after Conventional Distal Gastrectomy for Gastric Cancer. Clinical Physiology, 45, 1-4.