Shunji Endo
   Department   Kawasaki Medical School  Kawasaki Medical School, Department of Digestive Surgery,
   Position   Associate Professor
Article types 原著
Language English
Peer review Peer reviewed
Title Motility of the pouch correlates with quality of life after total gastrectomy.
Journal Formal name：Surgery
Abbreviation：Surgery
ISSN code：00396060/00396060
Domestic / ForeginForegin
Volume, Issue, Page 139(4),pp.493-500
Author and coauthor Endo Shunji, Nishida Toshirou, Nishikawa Kazuhiro, Yumiba Takeyoshi, Nakajima Kiyokazu, Yasumasa Keigo, Kitagawa Toru, Ito Toshinori, Matsuda Hikaru
Publication date 2006/04
Summary BACKGROUND:Jejunal pouch reconstruction is used to provide reservoir function after total gastrectomy, but controversy remains regarding pouch functions and quality of life (QOL). In this study, pouch motility was studied in conjunction with postoperative QOL.METHODS:Pouch motility of 23 patients with jejunal pouch interposition after total gastrectomy was examined by manometry under fasting conditions and by an emptying test using dual-scintigraphy under postprandial conditions. Residual food was graded by endoscopic examinations. QOL was evaluated using the Gastrointestinal Quality of Life Index, and a stasis- or dumping-related symptom score.RESULTS:The pouch showed interdigestive contractile activity. Bursts of contractile activity occurred frequently and were long-lasting compared with the migrating motor complex phase III of the control jejunum. The percentage of time of contractile bursts correlated with postprandial pouch emptying (liquid: R(2) = 0.229, P < .03; solid: R(2) = 0.243, P < .02). Patients with little or no residual food had more percentage of time of contractile bursts than those with moderate residual food (P < .01). The percentage of time of contractile bursts was correlated with the Gastrointestinal Quality of Life Index score (R(2) = 0.262, P < .02), stasis-related symptoms (R(2) = 0.279, P < .01), and dumping-related symptoms (R(2) = 0.218, P < .03).CONCLUSIONS:An interposed jejunum pouch showed bursts of contractile activity that affected postoperative gastrointestinal function and patient QOL.
DOI 10.1016/j.surg.2005.08.013
PMID 16627058