Symptom evaluation of long-term postoperative outcomes after pylorus-preserving gastrectomy for early gastric cancer.
BACKGROUND
Since the early 1990s, pylorus-preserving gastrectomy (PPG) has been used in the treatment of patients with early gastric cancer in order to reduce postprandial symptoms. To date, there have been few reports of long-term symptom evaluation following this procedure. The aim of this study was to evaluate long-term postoperative outcomes after PPG.


METHODS
Three hundred and ninety-seven patients with early gastric cancer were enrolled in this study: 194 patients who underwent PPG and 203 who underwent distal gastrectomy with Billroth-I reconstruction (DGBI). We compared the symptoms for the two groups in a questionnaire on postoperative functional outcomes, endoscopy findings and the appearance of gallstones after surgery.


RESULTS
The incidence of symptoms suggesting early dumping syndrome was significantly lower in the PPG group compared with the DGBI group (P < 0.05). The incidences of disturbed bowel habit and frequent flatus were significantly lower in the PPG than in the DGBI group. The average relative body weight (actual BW/ BW immediately before the surgery) was significantly better in the PPG than in the DGBI group (P < 0.001).


CONCLUSIONS
The long-term results show that PPG has clear advantages over DGBI in terms of postoperative symptoms and functional outcomes. These results imply that PPG should be the recommended procedure for early gastric cancers located in the middle third of the stomach.
Nunobe
Souya
S
Department of Surgery, National Cancer Center Hospital, Tokyo 104-0045, Japan.
Sasako
Mitsuru
M
Saka
Makoto
M
Fukagawa
Takeo
T
Katai
Hitosho
H
Sano
Takeshi
T
D001835:Body Weight; D004377:Dumping Syndrome / Q000503:physiopathology; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000209:etiology; D005743:Gastrectomy / Q000379:methods*; D005746:Gastric Emptying / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011178:Postgastrectomy Syndromes / Q000503:physiopathology*; D011446:Prospective Studies; D011708:Pylorus / Q000378:metabolism*; D013274:Stomach Neoplasms / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome