title: Postoperative clinical evaluation following pylorus-preserving gastrectomy.
abstract: OBJECTIVE
  Recent pathological study demonstrated that extended lymphadenectomy is not always necessary for patients with early gastric cancer.
  
  
  METHODS
  Twenty-eight patients underwent pylorus-preserving gastrectomy. The clinicopathological findings of patients with pylorus-preserving gastrectomy were compared to those of 58 patients with conventional distal gastrectomy.
  
  
  RESULTS
  There were no significant differences in surgical duration, blood loss, blood chemistry, food intake, and body weight loss. Regarding abdominal symptoms, early dumping syndrome was significantly higher in distal gastrectomy than in pylorus-preserving gastrectomy (35.6% vs. 12.0%, p<0.05). Remnant gastritis was also significantly higher in distal gastrectomy (57.1% vs. 27.7%, p<0.05). However, food residue tended to be more frequently seen in pylorus-preserving gastrectomy (33.3% vs. 61.1%, p=0.052). Based on questionnaire results, the rate of patient satisfaction with their surgical outcome tended to be lower in pylorus-preserving gastrectomy than in distal gastrectomy (84.0% vs. 95.6%, p=0.098). The tendency was more pronounced in patients over 70 years old (77.8% vs. 100%, p=0.065).
  
  
  CONCLUSIONS
  Pylorus-preserving gastrectomy is superior to conventional distal gastrectomy in the prevention of dumping syndrome and reflux gastritis. However, since delayed emptying is frequently seen post pylorus-preserving gastrectomy, this procedure is not recommended for older patients under simplistic indications.
authors.affiliation: Department of Surgery, Kyoto First Red Cross Hospital, Kyoto, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ichikawa
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kurioka
authors.forename: Hisashi
authors.initials: H
authors.lastname: Ikoma
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Koike
authors.forename: Eigo
authors.initials: E
authors.lastname: Otsuji
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ueshima
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shioaki
authors.forename: Chol Joo
authors.initials: CJ
authors.lastname: Lee
authors.forename: Takashi
authors.initials: T
authors.lastname: Hamashima
authors.forename: Eiichi
authors.initials: E
authors.lastname: Deguchi
authors.forename: Eito
authors.initials: E
authors.lastname: Ikeda
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Mutoh
authors.forename: Hisakazu
authors.initials: H
authors.lastname: Yamagishi
mesh_terms: D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011708:Pylorus; D011788:Quality of Life; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*