Proper preparation to reduce endoscopic reexamination due to food residue after distal gastrectomy for gastric cancer.
BACKGROUND
Reducing food residue by proper preparation methods before endoscopy after distal gastrectomy can increase the quality of examination and decrease patient discomfort. We evaluated the risk factors for food residue and proper methods of preparation for endoscopy after distal gastrectomy.


METHODS
Follow-up endoscopy with questionnaires was performed on 1,001 patients who underwent distal gastrectomy at Asan Medical Center between December 2010 and July 2011.


RESULTS
Endoscopic examination failed in 94 patients (9.4 %) as a result of large amounts of food residue. Rates of failure were significantly higher in patients who ate a regular diet rather than a soft diet at last dinner before examination (13.9 vs. 6.1 %, p = 0.050), and in those who ate lunch rather than not eating lunch on the day before examination (14.6 vs. 7.7 %, p = 0.020). Multivariate analysis showed that the rate of failed examination was lower in patients who had a history of abdominal surgery (p = 0.011), those who ate a soft (p < 0.001) or liquid (p = 0.003) diet as a last meal rather than a regular diet, those who underwent Billroth I rather than Billroth II reconstruction (p = 0.035), patients with longer fasting time (p = 0.009), and those with a longer gastrectomy-to-endoscopy time interval (p < 0.001).


CONCLUSIONS
Patients who undergo follow-up endoscopy after surgery should fast more than 18 h and ingest a soft or liquid diet on the day before examination.
Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, no. 388-1 Pungnap-2 dong, Songpa-gu, Seoul 138-736, Korea. ji110@hanmail.net
Ji Yong
JY
Ahn
Hwoon-Yong
HY
Jung
Sue Eun
SE
Bae
Ji Hoon
JH
Jung
Ji Young
JY
Choi
Mi-Young
MY
Kim
Jeong Hoon
JH
Lee
Kwi-Sook
KS
Choi
Do Hoon
DH
Kim
Kee Don
KD
Choi
Ho June
HJ
Song
Gin Hyug
GH
Lee
Jin-Ho
JH
Kim
Seungbong
S
Han
D000368:Aged; D004032:Diet; D005215:Fasting; D005260:Female; D005502:Food; D005743:Gastrectomy / Q000379:methods*; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D019233:Retreatment; D013274:Stomach Neoplasms / Q000601:surgery*; D017211:Treatment Failure