Risk Factors for Food Residue after Distal Gastrectomy and a New Effective Preparation for Endoscopy: The Water-Intake Method
1
조회
0
다운로드
3
인용
0
참고문헌
초록
Background/Aims: Food residue is frequently observed in the gastric remnant after distal gastrectomy, despite adequate preparation. We devised a water-intake method to reduce food residue in the gastric remnant by drinking large quantities of water in a short time. The aims of this study were to identify the risk factors for food residue and to study the effectiveness of this new method for endoscopy preparation. Methods: A cohort of 708 patients who underwent distal gastrectomy for gastric cancer was reviewed prospectively. Sixty patients with large amounts of food residue were randomly divided into two groups: a water-intake group (n=40) and a prolonged fasting group (n=20). Results: The incidences of a large amount of food residue were 15.7%, 5.8%, 7.5%, and 2.8% at 3, 12, 24, and 36 months, respectively, after distal gastrectomy. Independent risk factors for food residue were endoscopy at 3 months, diabetes mellitus, a body mass index of ＜19.5, and laparoscopic surgery. The proportion of successful preparations at follow-up endoscopy was higher for the water-intake group (70%) than for the prolonged fasting group (40%, p=0.025). Conclusions: The water- intake method can be recommended as a preparation for endoscopy in patients who have had repetitive food residue or risk factors after distal gastrectomy.
Abstract
Background/Aims: Food residue is frequently observed in the gastric remnant after distal gastrectomy, despite adequate preparation. We devised a water-intake method to reduce food residue in the gastric remnant by drinking large quantities of water in a short time. The aims of this study were to identify the risk factors for food residue and to study the effectiveness of this new method for endoscopy preparation. Methods: A cohort of 708 patients who underwent distal gastrectomy for gastric cancer was reviewed prospectively. Sixty patients with large amounts of food residue were randomly divided into two groups: a water-intake group (n=40) and a prolonged fasting group (n=20). Results: The incidences of a large amount of food residue were 15.7%, 5.8%, 7.5%, and 2.8% at 3, 12, 24, and 36 months, respectively, after distal gastrectomy. Independent risk factors for food residue were endoscopy at 3 months, diabetes mellitus, a body mass index of ＜19.5, and laparoscopic surgery. The proportion of successful preparations at follow-up endoscopy was higher for the water-intake group (70%) than for the prolonged fasting group (40%, p=0.025). Conclusions: The water- intake method can be recommended as a preparation for endoscopy in patients who have had repetitive food residue or risk factors after distal gastrectomy.
참고문헌 (19)
- Takeno S, "Early and late gastric cancer arising in the remnant stomach after distal gastrectomy", Eur J Surg Oncol, 32, pp.1191~1194 (2006)
- Nozaki I, "Higher incidence of gastric remnant cancer after proximal than distal gastrectomy", Hepatogastroenterology, 54, pp.1604~1608 (2007)
- Firat O, "Gastric remnant cancer: an old problem with novel concerns", Langenbecks Arch Surg, 394, pp.93~97 (2009)
- Hirasaki S, "Treatment of gastric remnant cancer post distal gastrectomy by endoscopic submucosal dissection using an insulation-tipped diathermic knife", World J Gastroenterol, 14, pp.2550~2555 (2008)
- Thorban S, "Prognostic factors in gastric stump carcinoma", Ann Surg, 231, pp.188~194 (2000)
- Song KY, "Is gastrectomy mandatory for all residual or recurrent gastric cancer following endoscopic resection?. in: A large-scale Korean multi-center study", J Surg Oncol, 98, pp.6~10 (2008)
- Kubo M, "Endoscopic evaluation of the remnant stomach after gastrectomy: proposal for a new classification", Gastric Cancer, 5, pp.83~89 (2002)
- Jung HJ, "The influence of reconstruction methods on food retention phenomenon in the remnant stomach after a subtotal gastrectomy", J Surg Oncol, 98, pp.11~14 (2008)
- Watanabe H, "Food residue at endoscopy in patients who have previously undergone distal gastrectomy: risk factors and patient preparation", Endoscopy, 35, pp.397~401 (2003)
- Nunobe S, "Incidence of gastric cancer in the remnant stomach after proximal gastrectomy", Hepatogastroenterology, 55, pp.1855~1858 (2008)
- Mees U, "Formation of a phytobezoar following surgery of the stomach: review of the literature", Acta Chir Belg, 84, pp.221~225 (1984)
- Ja Young Lee, "No Changing Trends in Incidence of Gastric Cardia Cancer in Korea", Journal of Korean Medical Science, 18(1), pp.53~57 (2003), 대한의학회
- Ohashi M, "Cancer of the gastric stump following distal gastrectomy for cancer", Br J Surg, 94, pp.92~95 (2007)
- Huguier M, "Early gastric carcinoma: spread and multicentricity", Gastric Cancer, 5, pp.125~128 (2002)
- Bearzi I, "Multifocal early gastric cancer: morphology and histogenesis", Pathol Res Pract, 181, pp.144~147 (1986)
- Kosaka T, "A clinicopathologic study on multiple gastric cancers with special reference to distal gastrectomy", Cancer, 65, pp.2602~2605 (1990)
- Otsuji E, "Clinicopathologic characteristics and prognosis of synchronous multifocal gastric carcinomas", Am J Surg, 189, pp.116~119 (2005)
- Rider JA, "Gastric bezoars: treatment and prevention", Am J Gastroenterol, 79, pp.357~359 (1984)
- Diettrich NA, "Postgastrectomy phytobezoars: endoscopic diagnosis and treatment", Arch Surg, 120, pp.432~435 (1985)