Studies on gastrointestinal hormone and jejunal interdigestive migrating motor complex in patients with or without early dumping syndrome after total gastrectomy with Roux-en-Y reconstruction for early gastric cancer.
BACKGROUND
There has been no report concerning fasting Roux limb motilities and gut hormone in patients with early dumping syndrome (EDS) after total gastrectomy with Roux-en-Y reconstruction. The present study investigated interdigestive migrating motor complex, phase III (IMMC-pIII) in the Roux limb, changes in the plasma gut hormone levels, and the relationships among those parameters and EDS.


METHODS
Forty-eight patients (35 men, 13 women; aged 33 to 69 years, mean, 59.8) 1.5 to 2.0 years (mean 1 year, 8 months) after total gastrectomy with Roux-en-Y reconstruction for early gastric cancer were allocated to two groups based on the presence or absence of EDS. The occurrence of IMMC-pIII was compared and changes in the plasma levels of both motilin (MT) and somatostatin (SOM) were monitored.


RESULTS
None of the patients with EDS (n = 8) were recognized as having IMMC-pIII. In the IMMC-pIII positive group, MT and SOM increased sequentially from phase I through IMMC-pIII. In the IMMC-pIII negative group, MT and SOM were significantly lower than in the IMMC-pIII positive group during phases I, II, and IMMC-pIII (P <0.05, P <0.01, P <0.01, respectively).


CONCLUSIONS
There is an absence of IMMC-pIII in patients with EDS, and both MT and SOM might be necessary for IMMC-pIII generation.
Tomita
Ryouichi
R
First Department of Surgery, Nihon University School of Medicine, Tokyo 173-0032, Japan. rtomita-ndus@mvg.biglobe.ne.jp
Fujisaki
Shigeru
S
Tanjoh
Katsuhisa
K
Fukuzawa
Masahiro
M
D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects*; D004377:Dumping Syndrome / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D005768:Gastrointestinal Hormones / Q000097:blood / Q000502:physiology*; D005769:Gastrointestinal Motility / Q000502:physiology; D006801:Humans; D007583:Jejunum / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009037:Motilin / Q000097:blood / Q000502:physiology; D016065:Myoelectric Complex, Migrating / Q000502:physiology*; D009367:Neoplasm Staging; D013004:Somatostatin / Q000097:blood / Q000502:physiology; D013274:Stomach Neoplasms / Q000601:surgery*
D005768:Gastrointestinal Hormones; D013004:Somatostatin; D009037:Motilin