Scoring system for evaluating functional disorders following laparoscopy-assisted distal gastrectomy.
BACKGROUND
Practical questionnaires for evaluating duodenogastric reflux following gastrectomy are currently unavailable. The present study evaluated the usefulness of the frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) questionnaire in the diagnosis of duodenogastric reflux after laparoscopy-assisted distal gastrectomy (LADG), which minimizes the risk of adhesions affecting the gastrointestinal tract.


METHODS
Subjects in this study comprised 163 patients who had undergone LADG (Billroth-I (B-I), n = 57, Roux-en-Y (R-Y), n = 106). All subjects underwent endoscopy at least 6 mo postoperatively. The FSSG questionnaire was administered a few weeks after endoscopy, and FSSG scores were compared with endoscopic findings.


RESULTS
In the R-Y group, FSSG scores were significantly higher in subjects with remnant gastritis than in those without (P = 0.002), and a significant correlation was seen between FSSG scores and bile reflux (P = 0.046). In the B-I group, FSSG scores were significantly higher in subjects with reflux esophagitis than in those without (P = 0.01), but degree of remnant gastritis and residual food did not correlate significantly with FSSG scores. With a cut-off FSSG score of six points, sensitivity and specificity for predicting remnant gastritis in R-Y reconstruction were 71% and 76%, respectively.


CONCLUSIONS
The FSSG questionnaire is a viable and less invasive alternative to other modalities for evaluating duodenogastric reflux in R-Y reconstruction, but is unsuitable for B-I reconstruction after LADG.
Enjoji
Megumu
M
Department of Esophagogastric Surgery, University Hospital of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
Yamada
Hiroyuki
H
Kojima
Kazuyuki
K
Inokuchi
Mikito
M
Kato
Keiji
K
Kawano
Tatsuyuki
T
Sugihara
Kenichi
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects / Q000379:methods; D015992:Body Mass Index; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods*; D005756:Gastritis / Q000150:complications / Q000601:surgery; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology; D012372:ROC Curve; D012189:Retrospective Studies; D011795:Surveys and Questionnaires