title: Assessment of motor function of the remnant stomach by ¹³C breath test with special reference to gastric local resection.
abstract: BACKGROUND
  Indications for gastric local resection (LR) include gastrointestinal stromal tumors, neuroendocrine tumors, and early gastric cancer. LR is expected to preserve physiological function and ameliorate postgastrectomy syndrome.
  
  
  METHODS
  Gastric emptying was assessed by the (13)C-acetate breath test in 20 healthy volunteers (HVs) and 60 gastrectomized patients [distal gastrectomy with Billroth I reconstruction (DGBI) in 26 patients, LR in 34 patients]. For the (13)C breath test, 100 mg of (13)C-acetate sodium salt was mixed in a test meal. Breath samples were collected before intake and during the next 3 h. We compared the gastric reservoir capacity using the gastric retention rate at 5 min (RR5) and gastric emptying by the half emptying time (T½). Patients completed a questionnaire survey about their symptoms, dietary intake, body weight, and restriction of activities of daily living [reflecting quality of life (QOL)].
  
  
  RESULTS
  The RR5 values for the HV, LR, and DGBI groups were 93.7, 90.0, and 45.3* %, respectively (*compared to HV and LR, p < 0.0001). The T½ values were 23.3, 20.2, and 5.9* min, respectively. Dietary intake and body weight change were significantly more reduced in the DGBI group than the LR group (p < 0.05). Subgroup analysis indicated that the reservoir capacity in those with LR at the lesser curvature was more disturbed than that in patients with LR at the greater curvature. The questionnaire showed no differences in those patients' QOL.
  
  
  CONCLUSIONS
  Because the reservoir capacity, the gastric emptying and QOL were maintained, LR is an option for selected patients with early gastric cancer.
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan, masahiko7877@jikei.ac.jp.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kawamura
authors.forename: Koji
authors.initials: K
authors.lastname: Nakada
authors.forename: Hideo
authors.initials: H
authors.lastname: Konishi
authors.forename: Taizo
authors.initials: T
authors.lastname: Iwasaki
authors.forename: Keishiro
authors.initials: K
authors.lastname: Murakami
authors.forename: Norio
authors.initials: N
authors.lastname: Mitsumori
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Hanyu
authors.forename: Nobuo
authors.initials: N
authors.lastname: Omura
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D001835:Body Weight; D001944:Breath Tests; D005260:Female; D005743:Gastrectomy; D005746:Gastric Emptying / Q000502:physiology; D018530:Gastric Stump / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011178:Postgastrectomy Syndromes / Q000503:physiopathology; D011788:Quality of Life; D013274:Stomach Neoplasms / Q000601:surgery*; D011795:Surveys and Questionnaires