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[PMID]: 28440518
[Au] Autor:Liang H; Lin S; Guan W
[Ad] Address:Department of Bariatric and Metabolic Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China. drhuiliang@126.com.
[Ti] Title:[Choice of bariatric and metabolic surgical procedures].
[So] Source:Zhonghua Wei Chang Wai Ke Za Zhi;20(4):388-392, 2017 Apr 25.
[Is] ISSN:1671-0274
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:Bariatric and metabolic surgery has become the clinical hot topic of the treatment of metabolic syndromes including obesity and diabetes mellitus, but how to choose the appropriate surgical procedure remains the difficult problem in clinical practice. Clinical guidelines of American Society for Metabolic and Bariatric Surgery(ASMBS)(version 2013) introduced the procedures of bariatric and metabolic surgery mainly including biliopancreatic diversion with duodenal switch(BPD-DS), laparoscopic adjustable gastric banding (LAGB), laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy(LSG). To choose the appropriate bariatric and metabolic procedure, the surgeons should firstly understand the indications and the contraindications of each procedure. Procedure choice should also consider personal condition (body mass index, comorbidities and severity of diabetes), family and socioeconomic status (postoperative follow-up attendance, understanding of potential surgical risk of gastrectomy and patient's will), family and disease history (patients with high risk of gastric cancer should avoid LRYGB; patients with gastroesophageal reflux disease should avoid LSG) and associated personal factors of surgeons. With the practice of bariatric and metabolic surgery, the defects, especially long-term complications, of different procedures were found. For example, LRYGB resulted in higher incidence of postoperative anemia and marginal ulcer, high risk of gastric cancer as well as the requirement of vitamin supplementation and regular follow-up. Though LSG has lower surgical risk, its efficacy of diabetes mellitus remission and long-term weight loss are inferior to the LRYGB. These results pose challenges to the surgeons to balance the benefits and risks of the bariatric procedures. A lot of factors can affect the choice of bariatric and metabolic procedure. Surgeons should choose the procedure according to patient's condition with the consideration of the choice of patients. The bariatric and metabolic surgery not only manages the diabetes mellitus and weight loss, but also results in the reconstruction of gastrointestinal tract and side effect. Postoperative surgical complications and nutritional deficiency should also be considered. Thereby, individualized bariatric procedure with the full consideration of each related factors is the ultimate objective of bariatric and metabolic surgery.
[Mh] MeSH terms primary: Bariatric Surgery/adverse effects
Bariatric Surgery/methods
Bariatric Surgery/statistics & numerical data
Biliopancreatic Diversion/adverse effects
Biliopancreatic Diversion/methods
Biliopancreatic Diversion/statistics & numerical data
Diabetes Mellitus/surgery
Disease Management
Gastrectomy/adverse effects
Gastrectomy/methods
Gastrectomy/statistics & numerical data
Gastric Bypass/adverse effects
Gastric Bypass/methods
Gastric Bypass/statistics & numerical data
Gastroplasty/mortality
Gastroplasty/methods
Gastroplasty/statistics & numerical data
Laparoscopy/methods
Laparoscopy/statistics & numerical data
Obesity/surgery
Patient Care Planning
Risk Assessment/methods
Treatment Outcome
[Mh] MeSH terms secundary: Anemia/epidemiology
Body Mass Index
Comorbidity
Contraindications
Gastroesophageal Reflux
Humans
Informed Consent
Laparoscopy/adverse effects
Long Term Adverse Effects/epidemiology
Malnutrition/epidemiology
Patient Acuity
Patient Compliance
Postgastrectomy Syndromes/epidemiology
Postoperative Complications/epidemiology
Risk Factors
Stomach Neoplasms/epidemiology
Weight Loss
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1709
[Cu] Class update date: 171116
[Lr] Last revision date:171116
[Js] Journal subset:IM
[Da] Date of entry for processing:170426
[St] Status:MEDLINE

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[PMID]: 28373774
[Au] Autor:Takahashi M; Terashima M; Kawahira H; Nagai E; Uenosono Y; Kinami S; Nagata Y; Yoshida M; Aoyagi K; Kodera Y; Nakada K
[Ad] Address:Masazumi Takahashi, Division of Gastroenterological Surgery, Yokohama Municipal Citizen's Hospital, Yokohama 240-8555, Japan.
[Ti] Title:Quality of life after total distal gastrectomy with Roux-en-Y reconstruction: Use of the Postgastrectomy Syndrome Assessment Scale-45.
[So] Source:World J Gastroenterol;23(11):2068-2076, 2017 Mar 21.
[Is] ISSN:2219-2840
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:AIM: To investigate the detrimental impact of loss of reservoir capacity by comparing total gastrectomy (TGRY) and distal gastrectomy with the same Roux-en-Y (DGRY) reconstruction. The study was conducted using an integrated questionnaire, the Postgastrectomy Syndrome Assessment Scale (PGSAS)-45, recently developed by the Japan Postgastrectomy Syndrome Working Party. METHODS: The PGSAS-45 comprises 8 items from the Short Form-8, 15 from the Gastrointestinal Symptom Rating Scale, and 22 newly selected items. Uni- and multivariate analysis was performed on 868 questionnaires completed by patients who underwent either TGRY ( = 393) or DGRY ( = 475) for stage I gastric cancer (52 institutions). Multivariate analysis weighed of six explanatory variables, including the type of gastrectomy (TGRY/DGRY), interval after surgery, age, gender, surgical approach (laparoscopic/open), and whether the celiac branch of the vagus nerve was preserved/divided on the quality of life (QOL). RESULTS: The patients who underwent TGRY experienced the poorer QOL compared to DGRY in the 15 of 19 main outcome measures of PGSAS-45. Moreover, multiple regression analysis indicated that the type of gastrectomy, TGRY, most strongly and broadly impaired the postoperative QOL among six explanatory variables. CONCLUSION: The results of the present study suggested that TGRY had a certain detrimental impact on the postoperative QOL, and the loss of reservoir capacity could be a major cause.
[Mh] MeSH terms primary: Gastrectomy/adverse effects
Postgastrectomy Syndromes/psychology
Quality of Life
Stomach Neoplasms/surgery
[Mh] MeSH terms secundary: Age Factors
Aged
Anastomosis, Roux-en-Y
Female
Gastrectomy/methods
Humans
Japan
Laparoscopy/adverse effects
Male
Middle Aged
Multivariate Analysis
Postgastrectomy Syndromes/etiology
Postoperative Period
Sex Factors
Stomach/innervation
Stomach/surgery
Surveys and Questionnaires
Time Factors
Treatment Outcome
Vagus Nerve/surgery
[Pt] Publication type:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Entry month:1709
[Cu] Class update date: 170914
[Lr] Last revision date:170914
[Js] Journal subset:IM
[Da] Date of entry for processing:170405
[St] Status:MEDLINE
[do] DOI:10.3748/wjg.v23.i11.2068

  3 / 2573 MEDLINE  
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[PMID]: 28325187
[Au] Autor:Davis JL; Ripley RT
[Ad] Address:Surgical Oncology Section, Thoracic & Gastrointestinal Oncology Branch, National Cancer Institute, 10 Center Drive, MSC1201, Room 4-3940, Bethesda, MD 20892, USA. Electronic address: Jeremy.Davis@nih.gov.
[Ti] Title:Postgastrectomy Syndromes and Nutritional Considerations Following Gastric Surgery.
[So] Source:Surg Clin North Am;97(2):277-293, 2017 Apr.
[Is] ISSN:1558-3171
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Postgastrectomy syndromes result from altered form and function of the stomach. Gastrectomy disrupts reservoir capacity, mechanical digestion and gastric emptying. Early recognition of symptoms with prompt evaluation and treatment is essential. Many syndromes resolve with minimal intervention or dietary modifications. Re-operation is not common but often warranted for afferent and efferent loop syndromes and bile reflux gastritis. Preoperative nutritional assessment and treatment of common vitamin and mineral deficiencies after gastrectomy can reduce the incidence of chronic complications. An integrated team approach to risk assessment, patient education, and postoperative management is critical to optimal care of patients with gastric cancer.
[Mh] MeSH terms primary: Postgastrectomy Syndromes/diet therapy
[Mh] MeSH terms secundary: Afferent Loop Syndrome/etiology
Afferent Loop Syndrome/surgery
Anastomosis, Roux-en-Y
Bile Reflux/etiology
Diarrhea/etiology
Dietary Supplements
Dumping Syndrome/diet therapy
Dumping Syndrome/etiology
Gastric Emptying/physiology
Gastric Stump/physiopathology
Gastritis/etiology
Gastroparesis/etiology
Humans
Malnutrition/diet therapy
Malnutrition/etiology
Postgastrectomy Syndromes/physiopathology
Postgastrectomy Syndromes/surgery
Reoperation
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1704
[Cu] Class update date: 170424
[Lr] Last revision date:170424
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:170323
[St] Status:MEDLINE

  4 / 2573 MEDLINE  
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[PMID]: 27751530
[Au] Autor:Hosoda K; Yamashita K; Sakuramoto S; Katada N; Moriya H; Mieno H; Watanabe M
[Ad] Address:Department of Surgery, Kitasato University School of Medicine, Kanagawa, Japan. Electronic address: k.hosoda@kitasato-u.ac.jp.
[Ti] Title:Postoperative quality of life after laparoscopy-assisted pylorus-preserving gastrectomy compared With laparoscopy-assisted distal gastrectomy: A cross-sectional postal questionnaire survey.
[So] Source:Am J Surg;213(4):763-770, 2017 Apr.
[Is] ISSN:1879-1883
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Little is known about postgastrectomy syndrome and quality of life (QOL after laparoscopy-assisted pylorus-preserving gastrectomy (LAPPG). The aim of this study was to assess postgastrectomy syndrome and QOL after LAPPG as compared with laparoscopy-assisted distal gastrectomy with Billroth-I reconstruction (LADGBI). METHODS: Postgastrectomy Syndrome Assessment Scale-45 (PGSAS-45) questionnaires were sent by mail to 167 patients. To balance the characteristics of the groups, propensity score matching was performed. RESULTS: Of the 167 patients sent questionnaires, 112 (67%) responded, including 47 who underwent LAPPG and 65 who underwent LADGBI. After propensity score matching, the LAPPG group scored significantly better on the diarrhea and dumping subscales. Multiple regression analysis showed that female sex and LADGBI were independent factors predicting dumping. Evaluation of outcome measures for singular symptom showed that the LAPPG group scored significantly worse on the acid regurgitation subscale, but significantly better on the lower abdominal pain and early dumping abdominal subscales. CONCLUSION: LAPPG is superior to LADGBI for ameliorating postgastrectomy syndrome and maintaining QOL. LAPPG is recommended for patients with cT1N0 middle third gastric cancer.
[Mh] MeSH terms primary: Gastrectomy/methods
Laparoscopy
Quality of Life
[Mh] MeSH terms secundary: Adult
Aged
Aged, 80 and over
Cross-Sectional Studies
Female
Gastroenterostomy
Humans
Male
Middle Aged
Postgastrectomy Syndromes/etiology
Postgastrectomy Syndromes/prevention & control
Propensity Score
Sex Factors
Stomach Neoplasms/surgery
Surveys and Questionnaires
[Pt] Publication type:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Entry month:1704
[Cu] Class update date: 170424
[Lr] Last revision date:170424
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:161019
[St] Status:MEDLINE

  5 / 2573 MEDLINE  
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[PMID]: 27357933
[Au] Autor:Konishi H; Nakada K; Kawamura M; Iwasaki T; Murakami K; Mitsumori N; Yanaga K
[Ad] Address:Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan. jsurgerykonishi@gmail.com.
[Ti] Title:Impaired Gastrointestinal Function Affects Symptoms and Alimentary Status in Patients After Gastrectomy.
[So] Source:World J Surg;40(11):2713-2718, 2016 Nov.
[Is] ISSN:1432-2323
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Postgastrectomy syndrome (PGS) remains a common complication after gastrectomy that affects patients' quality of life. Although impaired gastrointestinal (GI) function by gastrectomy procedures is thought to be the cause, the precise pathophysiology of PGS is yet to be clarified. AIM: The aim of this study was to investigate relationships between GI function and various symptoms or alimentary status in patients after gastrectomy. METHODS: Fifty-one patients who underwent total or distal gastrectomy at least 1 year previously were studied. All patients replied to a questionnaire that asked presence of symptoms (esophageal reflux, nausea, abdominal pain, early satiation, diarrhea, early dumping general, early dumping abdominal, and late dumping symptoms) and alimentary status (change in body weight, food intake per meal, frequency of meals per day). They also underwent assessment of GI function consisting of gastric emptying study by C-acetate breath test to examine reservoir capacity and gastric emptying, and water load drink test to evaluate tolerance to volume loading (TVL). The relationships between GI function and each symptom or alimentary status were examined. RESULTS: The patients with nausea and early dumping general symptoms had significantly smaller reservoir capacity*, the patients with diarrhea and early dumping general symptoms had significantly faster gastric emptying*, and the patients with early satiation and early dumping abdominal symptoms had significantly impaired TVL*. Significant correlations were identified between TVL and body weight changes* or food intake per meal* (* p < 0.05). CONCLUSION: Impaired postoperative GI function was closely related to symptoms or worse alimentary status.
[Mh] MeSH terms primary: Adenocarcinoma/surgery
Gastrectomy/adverse effects
Postgastrectomy Syndromes/diagnosis
Postgastrectomy Syndromes/physiopathology
Stomach Neoplasms/surgery
[Mh] MeSH terms secundary: Adenocarcinoma/physiopathology
Aged
Anastomosis, Surgical/adverse effects
Female
Gastrectomy/methods
Humans
Male
Middle Aged
Postgastrectomy Syndromes/etiology
Quality of Life
Stomach Neoplasms/physiopathology
Surveys and Questionnaires
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171026
[Lr] Last revision date:171026
[Js] Journal subset:IM
[Da] Date of entry for processing:160701
[St] Status:MEDLINE

  6 / 2573 MEDLINE  
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[PMID]: 27318467
[Au] Autor:Stier C; Chiappetta S
[Ad] Address:Department of Obesity and Metabolic Surgery, Sana Klinikum Offenbach, Offenbach am Main, Germany. christinestier@googlemail.com.
[Ti] Title:Endoluminal Revision (OverStitch (TM) , Apollo Endosurgery) of the Dilated Gastroenterostomy in Patients with Late Dumping Syndrome After Proximal Roux-en-Y Gastric Bypass.
[So] Source:Obes Surg;26(8):1978-84, 2016 08.
[Is] ISSN:1708-0428
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Dumping syndrome is a long-term postoperative complication of Roux-en-Y gastric bypass procedures. Morphologically, dumping syndrome usually correlates with a dilatation of the gastroenterostomy with accelerated pouch emptying. Conservative therapy includes diet changes, complementary pharmacotherapy and, if symptoms persist, surgical revision. Surgical options include endoscopic, endoluminal surgery to constrict the gastrojejunostomy using a novel endoscopic suturing device (OverStitch(TM), Apollo). In our study, we aimed to assess the viability, safety and efficacy of this procedure in patients with late dumping; 14 patients who had developed late dumping syndrome underwent surgery using an endoscopic suturing technique (OverStitch(TM), Apollo). Late dumping was confirmed by Sigstad score and an oral glucose tolerance test (OGTT). Prior to surgery, objective analysis of pouch emptying speed was assessed by gastric scintigraphy. Surgery was performed under general anaesthesia. None of the 14 patients suffered intra- or postoperative complications. No postsurgical increase in inflammation parameters was observed. The postinterventional pain scale (visual analogue scale) showed a mean score of 0.5 (range 0-10). In 13 of the 14 patients, no dumping was observed 1-month postsurgery. The postoperative Sigstad score (3.07 ± 2.06; range 1-9) showed an impressive reduction compared with the preoperative score (12.71 ± 4.18; range 7-24) (p < 0.001). Postoperative upper gastrointestinal gastrografin swallow revealed regular emptying in all the patients. The endoluminal endoscopic suturing technique-applied here for surgical revision of gastroenterostomy following Roux-en-Y gastric bypass-represents a promising, novel therapeutic option in late dumping syndrome involving minimal trauma and offering rapid reconvalescence.
[Mh] MeSH terms primary: Dumping Syndrome/surgery
Gastric Bypass/adverse effects
Gastroenterostomy/adverse effects
Obesity, Morbid/surgery
Postoperative Complications/surgery
Reoperation/methods
Suture Techniques
[Mh] MeSH terms secundary: Adult
Dumping Syndrome/etiology
Endoscopy, Gastrointestinal/adverse effects
Endoscopy, Gastrointestinal/methods
Esophagus/surgery
Female
Gastric Bypass/methods
Gastroenterostomy/methods
Humans
Length of Stay
Male
Middle Aged
Postgastrectomy Syndromes/surgery
Postoperative Period
Reoperation/adverse effects
Suture Techniques/adverse effects
Treatment Outcome
[Pt] Publication type:CLINICAL TRIAL; JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171124
[Lr] Last revision date:171124
[Js] Journal subset:IM
[Da] Date of entry for processing:160620
[St] Status:MEDLINE
[do] DOI:10.1007/s11695-016-2266-1

  7 / 2573 MEDLINE  
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[PMID]: 25637175
[Au] Autor:Fujita J; Takahashi M; Urushihara T; Tanabe K; Kodera Y; Yumiba T; Matsumoto H; Takagane A; Kunisaki C; Nakada K
[Ad] Address:Department of Surgery, NTT West Osaka Hospital, 2-6-40 Karasugatsuji Tennoji-ku, Osaka, 543-8922, Japan. j.fujita@mhc.west.ntt.co.jp.
[Ti] Title:Assessment of postoperative quality of life following pylorus-preserving gastrectomy and Billroth-I distal gastrectomy in gastric cancer patients: results of the nationwide postgastrectomy syndrome assessment study.
[So] Source:Gastric Cancer;19(1):302-11, 2016 Jan.
[Is] ISSN:1436-3305
[Cp] Country of publication:Japan
[La] Language:eng
[Ab] Abstract:BACKGROUND: Pylorus-preserving gastrectomy (PPG) is increasingly being used to treat early gastric cancer in the middle third of the stomach, with the hope of ameliorating postoperative dysfunction and improving quality of life (QOL). We evaluated symptoms of postgastrectomy syndrome (PGS) and QOL by means of a newly developed integrated questionnaire, the Postgastrectomy Syndrome Assessment Scale-45 (PGSAS-45), and compared PPG with Billroth-I distal gastrectomy (DGBI). METHODS: The PGSAS-45 consists of 45 items, including items from the SF-8 and GSRS instruments, as well as 22 newly selected items. It was designed to assess the severity of PGS and the living status and QOL of gastrectomized patients. The nationwide PGSAS surveillance study enrolled 2,368 gastric cancer patients who underwent various types of gastrectomy. In this study we analyzed 313 PPG patients and 909 DGBI patients. RESULTS: Body weight loss was -6.9% in the PPG group and -7.9% in the DGBI group (P = 0.052). The PPG group scored better on the diarrhea subscale (PPG; 1.8 vs. DGBI; 2.1, P < 0.0001), dumping subscale (1.8 vs. 2.0, P = 0.003), and frequency of additional meals (1.8 vs. 1.9, P = 0.034). Multiple regression analysis revealed that age and the preservation of the celiac branch of the vagus nerve were independent factors predicting diarrhea and dumping. CONCLUSIONS: It has been suggested that PPG is superior to DGBI for ameliorating PGS. Preservation of the celiac branch of the vagus nerve is recommended to reduce postoperative disorders regardless of the reconstruction method used.
[Mh] MeSH terms primary: Gastrectomy/methods
Postgastrectomy Syndromes/etiology
Quality of Life
Stomach Neoplasms/surgery
[Mh] MeSH terms secundary: Aged
Cross-Sectional Studies
Female
Gastrectomy/adverse effects
Gastroenterostomy
Humans
Male
Middle Aged
Postoperative Period
Pylorus/surgery
Retrospective Studies
Surveys and Questionnaires
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Entry month:1701
[Cu] Class update date: 171013
[Lr] Last revision date:171013
[Js] Journal subset:IM
[Da] Date of entry for processing:150201
[St] Status:MEDLINE
[do] DOI:10.1007/s10120-015-0460-9

  8 / 2573 MEDLINE  
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[PMID]: 27017739
[Au] Autor:Lychkova AE; Puzikov AM
[Ti] Title:[THE DIGESTIVE TRACT MOTILITY AND NUTRITIONAL SUPPORT WITH POSTGASTRORESECTIONAL SYNDROME].
[So] Source:Eksp Klin Gastroenterol;(8):25-9, 2015.
[Is] ISSN:1682-8658
[Cp] Country of publication:Russia (Federation)
[La] Language:rus
[Ab] Abstract:The variety of clinical manifestations operated stomach fits in the sequence of pathological syndromes: dumping and hypoglycemic syndromes, postgastroresectional post gastrectomy anemia, afferent loop syndrome, postoperative dystrophy, reflux esophagitis, a syndrome of "small" stomach, and hypoglycemic syndrome. Aim--to elucidate the role of disorders of motor function of the gastrointestinal tract in postgastroresectional syndromes and their correction. The nutrient administration reduced a motor function level of the stomach, restore motor function of the duodenum and ascending colon intestine, normalize ino- and chronotropic relations in the smooth muscles of the sigmoid colon.
[Mh] MeSH terms primary: Colon/physiopathology
Duodenum/physiopathology
Gastrointestinal Motility
Nutritional Support
Postgastrectomy Syndromes/physiopathology
[Mh] MeSH terms secundary: Female
Humans
Male
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1604
[Cu] Class update date: 160328
[Lr] Last revision date:160328
[Js] Journal subset:IM
[Da] Date of entry for processing:160329
[St] Status:MEDLINE

  9 / 2573 MEDLINE  
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[PMID]: 26939418
[Au] Autor:Lazirskiy VA
[Ti] Title:[RESULTS OF GASTROPLASTY, USING ILEOCECAL SEGMENT OF INTESTINE AFTER COMBINED GASTRECTOMY].
[So] Source:Klin Khir;(11):13-6, 2015 Nov.
[Is] ISSN:0023-2130
[Cp] Country of publication:Ukraine
[La] Language:rus
[Ab] Abstract:Results of treatment of 18 patients for locally spread gastric cancer, in whom after combined gastrectomy gastroplasty was accomplished, using ileocecal intestinal segment (the main group), were presented. In a comparison group 20 patients were included, in whom after combined gastrectomy end-to-loop esophagojejunoanastomosis was formated. Early postoperative complications have occurred in the main group--in 7 (38.8%) patients, and in comparison group--in 6 (30%). Postoperatively 2 (11.1%) and 2 (10%) patients died, accordingly. Gastroplasty, using ileo-cecal intestinal segment, have promoted reduction of the remote postgastrectomy syndromes occurrence rate from 58.8 to 11.1%. In a comparison group median survival was 18.6 mo, and in the main--a survival mediana was not achieved, because the investigation still goes on.
[Mh] MeSH terms primary: Cecum/surgery
Gastrectomy/adverse effects
Ileum/surgery
Peritonitis/pathology
Postgastrectomy Syndromes/pathology
Postoperative Complications
Thrombosis/pathology
[Mh] MeSH terms secundary: Anastomosis, Surgical
Esophagus/surgery
Female
Gastroplasty/methods
Humans
Jejunum/surgery
Male
Middle Aged
Peritonitis/etiology
Peritonitis/mortality
Postgastrectomy Syndromes/etiology
Postgastrectomy Syndromes/mortality
Postoperative Period
Stomach Neoplasms/pathology
Stomach Neoplasms/surgery
Survival Analysis
Thrombosis/etiology
Thrombosis/mortality
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1603
[Cu] Class update date: 161018
[Lr] Last revision date:161018
[Js] Journal subset:IM
[Da] Date of entry for processing:160305
[St] Status:MEDLINE

  10 / 2573 MEDLINE  
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SciELO Brazil full text

[PMID]: 26734789
[Au] Autor:da Silva AL; Gomes CG
[Ad] Address:Clinics Hospital, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
[Ti] Title:ASSESSMENT OF THE GASTRO-JEJUNO-DUODENAL TRANSIT AFTER JEJUNAL POUCH INTERPOSITION.
[So] Source:Arq Bras Cir Dig;28(4):231-3, 2015 Nov-Dec.
[Is] ISSN:2317-6326
[Cp] Country of publication:Brazil
[La] Language:eng; por
[Ab] Abstract:BACKGROUND: The jejunal pouch interposition between the gastric body and the duodenum after the gastrectomy, although not frequent in the surgical practice today, has been successfully employed for the prevention and treatment of the postgastrectomy syndromes. In the latter, it is included the dumping syndrome, which affects 13-58% of the patients who undergo gastrectomy. AIM: Retrospective assessment of the results of this procedure for the prevention of the dumping syndrome. METHODS: Fourty patients were selected and treatetd surgically for peptic ulcer, between 1965 and 1970. Of these, 29 underwent vagotomy, antrectomy, gastrojejunalduodenostomy at the lesser curvature level, and the 11 remaining were submitted to vagotomy, antrectomy, gastrojejunal-duodenostomy at the greater curvature level. The gastro-jejuno-duodenal transit was assessed in the immediate or late postoperative with the contrasted study of the esophagus, stomach and duodenum. The clinical evolution was assessed according to the Visick grade. RESULTS: Of the 40 patients, 28 were followed with the contrast evaluation in the late postoperative. Among those who were followed until the first month (n=22), 20 (90%) had slow gastro-jejuno-duodenal transit and in two (10%) the transit was normal. Among those who were followed after the first month (n=16), three (19%) and 13 (81%) had slow and normal gastric emptying, respectively. None had the contrasted exam compatible with the dumping syndrome. Among the 40 patients, 22 underwent postoperative clinical evaluation. Of these, 19 (86,5%) had excellent and good results (Visick 1 and 2, respectively). CONCLUSIONS: The jejunal pouch interposition showed to be a very effective surgical procedure for the prevention of the dumping syndrome in gastrectomized patients.
[Mh] MeSH terms primary: Dumping Syndrome/prevention & control
Duodenum/physiology
Duodenum/surgery
Gastrointestinal Transit
Jejunum/physiology
Jejunum/surgery
Stomach/physiology
Stomach/surgery
[Mh] MeSH terms secundary: Adult
Anastomosis, Surgical
Dumping Syndrome/etiology
Female
Gastrectomy/adverse effects
Humans
Male
Retrospective Studies
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1610
[Cu] Class update date: 161230
[Lr] Last revision date:161230
[Js] Journal subset:IM
[Da] Date of entry for processing:160107
[St] Status:MEDLINE


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