胃上部癌に対する噴門側胃切除，食道胃管吻合の術後胃排出能とＱＯＬ

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  • POSTOPERATIVE GASTRIC EMPTYING AND QOL IN RECONSTRUCTION PROCEDURE USING GASTRIC TUBE AFTER PROXIMAL GASTRECTOMY FOR UPPER GASTRIC CANCER

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This study was designed to clarify the postoperative QOL and gastric emptying in reconstruction procedure using gastric tube after proximal gastrectomy for upper gastric cancer. Subjects were 15 cases undergone this reconstruction method. The indications were early cancer located near the E-C junction without the indication of wedge resection, and advanced cancer located in the upper portion in high risk cases. In this method, the dissection of lymph node was limited in No1, 2, 3, 7, and the length of gastric tube was 20-25cm.<br>The patient's QOL was evaluated in terms of the changes in oral intake and body weight, symptoms, findings of gastrofiberscopy and gastric emptying by acetaminophen. The volume of oral intake and body weight recovered to preoperative levels one year after the operation in 8 out of 15 cases. The postprandial heavy feelings were observed in one case, but no bezoar was observed in this method. Endoscopic findings of reflux esophagitis were present in three out of 12 cases. This method showed a rapid gastric emptying function samely as distal gastrectomy with Billroth's I reconstruction.<br>In conclusion, the method of reconstruction using gastric tube after proximal gastrectomy for upper gastric cancer was easy and simple, and the postoperative QOL was well-preserved.

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