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Nutritional assessment of patients after pylorus-preserving gastrectomy for early gastric cancer.

ABSTRACT:

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The aim of this study was to evaluate the nutritional advantages of pylorus-preserving gastrectomy (PPG) in comparison with distal gastrectomy with Billroth I anastomosis (DG) in early gastric cancer (EGC). Between 2005 and 2007, 24 patients underwent PPG and 30 underwent DG. Subjective global assessment, objective data assessment, and endoscopic findings of the remnant stomach were compared between the two groups. Two years after surgery, the patients' body weights recovered to 97% in PPG, but they continued to decrease in DG. Postoperative blood lymphocyte counts remained low in DG, but recovered to preoperative levels 6 months after surgery in PPG. Food residue in the gastric remnant was frequently observed in PPG (71.4%) than in DG (15.8%, P?=?0.001). In nutritional aspect, PPG may be a more ideal operation than DG. However, food residue in the gastric remnant should be considered in PPG.

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The online version of this article (doi:10.1007/s12262-010-0167-4) contains supplementary material, which is available to authorized users.

SUBMITTER: Ikeguchi M

PROVIDER: S-EPMC3077201 | biostudies-literature | 2010 Dec

REPOSITORIES: biostudies-literature

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Nutritional assessment of patients after pylorus-preserving gastrectomy for early gastric cancer.

Ikeguchi Masahide M Kuroda Hirohiko H Kihara Kyouichi K Hatata Tomoko T Matsunaga Tomoyuki T Fukuda Kenji K Saito Hiroaki H Tatebe Shigeru S

The Indian journal of surgery 20101117 6

<h4>Unlabelled</h4>The aim of this study was to evaluate the nutritional advantages of pylorus-preserving gastrectomy (PPG) in comparison with distal gastrectomy with Billroth I anastomosis (DG) in early gastric cancer (EGC). Between 2005 and 2007, 24 patients underwent PPG and 30 underwent DG. Subjective global assessment, objective data assessment, and endoscopic findings of the remnant stomach were compared between the two groups. Two years after surgery, the patients' body weights recovered ...[more]

PMID: 22131654

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Project description:BackgroundThe aim of this meta-analysis was to compare the long-term survival, mortality, morbidity and the operation-related events in patients with periampullary and pancreatic carcinoma undergoing pylorus-preserving pancreaticoduodenectomy (PPPD) and pylorus-resecting pancreaticoduodenectomy (PRPD).MethodA systematic search of literature databases (Cochrane Library, PubMed, EMBASE and Web of Science) was performed to identify studies. Outcome measures comparing PPPD versus PRPD for periampullary and pancreatic carcinoma were long-term survival, mortality, morbidity (overall morbidity, delayed gastric emptying [DGE], pancreatic fistula, wound infection, postoperative bleeding, biliary leakage, ascites and gastroenterostomy leakage) and operation related events (hospital stays, operating time, intraoperative blood loss and red blood cell transfusions).ResultsEight randomized controlled trials (RCTs) including 622 patients were identified and included in the analysis. Among these patients, it revealed no difference in long-term survival between the PPPD and PRPD groups (HR = 0.23, p = 0.11). There was a lower rate of DGE (RR = 2.35, p = 0.04, 95% CI, 1.06-5.21) with PRPD. Mortality, overall morbidity, pancreatic fistula, wound infection, postoperative bleeding, biliary leakage, ascites and gastroenterostomy leakage were not significantly different between the groups. PPPDs were performed more quickly than PRPDs (WMD = 53.25 minutes, p = 0.01, 95% CI, 12.53-93.97); and there was less estimated intraoperative blood loss (WMD = 365.21 ml, p = 0.006, 95% CI, 102.71-627.71) and fewer red blood cell transfusions (WMD = 0.29 U, p = 0.003, 95% CI, 0.10-0.48) in patients undergoing PPPD. The hospital stays showed no significant difference.ConclusionsPPPD had advantages over PRPD in operating time, intraoperative blood loss and red blood cell transfusions, but had a significantly higher rate of DGE for periampullary and pancreatic carcinoma. PPPD and PRPD had comparable mortality and morbidity including pancreatic fistulas, wound infections, postoperative bleeding, biliary leakage, ascites and gastroenterostomy leakage. Our conclusions were limited by the available data. Further evaluations of high-quality RCTs are needed.

Dataset Information

Nutritional assessment of patients after pylorus-preserving gastrectomy for early gastric cancer.

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Electronic supplementary material

Publications

Nutritional assessment of patients after pylorus-preserving gastrectomy for early gastric cancer.

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