title: Restoration of gastrointestinal motility ameliorates nutritional deficiencies and body weight loss of patients who undergo laparoscopy-assisted proximal gastrectomy.
abstract: Esophagogastrostomy after proximal gastrectomy (PG) is a simple and safe reconstruction, but it leads to a high incidence of reflux esophagitis and impairs postoperative quality of life. We have already reported gastric tube (GT) reconstruction after PG and performed it on more than 100 patients. No studies have reported long-term outcomes after PG-GT. The aim of this study was to investigate long-term outcomes, including nutrition indices, such as body weight, serum albumin, total protein, hemoglobin, and ferritin after PG, and observe recovery of upper gastrointestinal tract motility.
  
  
  
  We analyzed body weight loss and laboratory findings at our outpatient clinic at 1, 6, 12, 24, 36, 48, and 60 months postoperatively. Manometric recording was carried out at 1, 2, 3, 4, and 5 years after surgery.
  
  
  
  The percentage change in body weight in the PG-GT group was significantly larger than that in the PG-JI and TG-RY groups at 2.5, 3, 4, and 5 years after surgery. The levels of hemoglobin and ferritin in the PG-GT and PG-JI groups were significantly higher than those in the TG-RY group at all time points except 6 months after surgery. In the fasted state, the phase III originated at the gastric tube was propagated to the duodenum 3 years after surgery. In the fed state, phasic contractions of the duodenum were in harmony with gastric tube contractions 3 years after surgery.
  
  
  
  PG-GT is the least invasive procedure, and restoration of gastrointestinal motilities in the gastric tube and duodenum may ameliorate body weight loss and nutritional status, including anemia, in patients after PG.
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan. m07702047@gunma-u.ac.jp.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Toyomasu
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Ogata
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Suzuki
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Yanoma
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Akiharu
authors.initials: A
authors.lastname: Kimura
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Norimichi
authors.initials: N
authors.lastname: Kogure
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yanai
authors.affiliation: Department of Surgery, Kajin-kai Chichibu Hospital, Chichibu, Saitama, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Ohno
authors.affiliation: Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
authors.forename: Erito
authors.initials: E
authors.lastname: Mochiki
authors.affiliation: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery; D000368:Aged; D000740:Anemia / Q000209:etiology / Q000517:prevention & control; D004946:Esophagostomy; D005260:Female; D005293:Ferritins / Q000097:blood; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D005769:Gastrointestinal Motility; D005774:Gastrostomy; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000601:surgery*; D015431:Weight Loss
chemical_list: D006454:Hemoglobins; D005293:Ferritins
keywords: Early gastric cancer; Laparoscopy-assisted proximal gastrectomy; Manometry