Role of pyloroplasty after proximal gastrectomy for cancer.
OBJECTIVE
The necessity of pyloroplasty as a drainage procedure after proximal gastrectomy remains controversial in terms of the postoperative quality of life. The aim of this retrospective study was to evaluate whether pyloroplasty is necessary after proximal gastrectomy.


METHODS
Thirty-five patients who underwent proximal gastrectomy with jejunal interposition between 1993 and 2000 were studied. They were divided into two groups: Group A, jejunal interposition without pyloroplasty (n=17); Group B, jejunal interposition with pyloroplasty (n=18). The subjects were interviewed and examined to assess their symptoms, food intake and body weight at 6, 12, and 24 months after the operation. Endoscopy and a radioisotope gastric emptying test were performed one year postoperatively.


RESULTS
A low incidence of epigastric fullness, nausea, and vomiting and a high frequency of patients with greater than 80% of pre-illness food intake were found in Group B. A high recovery of bodyweight was also achieved in Group B. On the other hand, a high incidence of reflux gastritis or bile regurgitation was found in Group B. Gastric emptying was significantly delayed in Group A.


CONCLUSIONS
Pyloroplasty as a drainage procedure after proximal gastrectomy is necessary in terms of the clinical symptoms, dietary intake, recovery of body weight, or gastric emptying.
Nakane
Yasushi
Y
2nd Department of Surgery, Kansai Medical University, Moriguchi, Osaka, Japan. nakaney@takii.kmu.ac.jp
Michiura
Taku
T
Inoue
Kentaro
K
Sato
Mutuya
M
Nakai
Koji
K
Ioka
Masaki
M
Yamamichi
Keigo
K
D000714:Anastomosis, Surgical; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D005746:Gastric Emptying / Q000502:physiology; D018530:Gastric Stump; D005773:Gastroscopy; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008297:Male; D009367:Neoplasm Staging; D017060:Patient Satisfaction; D011178:Postgastrectomy Syndromes / Q000209:etiology / Q000517:prevention & control*; D011336:Probability; D011706:Pyloric Antrum / Q000601:surgery*; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome