Clinical features of gastric emptying after distal gastrectomy

Kim, Daehoon; Yun, Hyo Yung; Song, Young‐Jin; Ryu, Dong Hee; Han, Hye‐Suk; Han, Joung-Ho; Kim, Ki Bae; Yoon, Soon Man; Youn, Sei Jin

doi:10.4174/astr.2017.93.6.310

Cited by 16 publications

(16 citation statements)

References 13 publications

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“…Another reason for FDGE might be the actual area of the anastomosis formed by the straight stapler is less than the anastomosis of the circular stapler with diameter over 25 mm, or it is more likely to cause anastomotic edema and mucosal accumulation, even the angle formation. This is consistent with the study by Kim KH [6] where he found that an anastomotic dilatation after a relatively small diameter of distal gastrectomy may be associated with a gradual improvement in FDGE. According to the above, we recommend that circular Fig.…”

Section: Discussionsupporting

confidence: 92%

“…Because of the small incision, the linear stapler cannot form the right angle of vertical gastric curvature in limited space, thus it causes the outflow track to rise. Dae Hoon Kim [6] proposed that laparoscopic distal gastrectomy is a risk factor for FDGE; this may be related to the mode of anastomosis. Another reason for FDGE might be the actual area of the anastomosis formed by the straight stapler is less than the anastomosis of the circular stapler with diameter over 25 mm, or it is more likely to cause anastomotic edema and mucosal accumulation, even the angle formation.…”

Section: Discussionmentioning

confidence: 99%

“…FDGE, which is a common complication after distal gastrectomy, has an incidence of 10% to 15% of which 5% to 10% with clinical symptoms. This complication not only causes patients to suffer from eating but also leads to the reduction of the patients' quality of life, and the increase of hospital stays and medical expenses, and the increase the workload and psychological pressure on doctors [5,6]. Most patients with FDGE recover after conservative treatment within 1-2 months, while few of them might need a longer time or even another operation.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of risk factors and prevention strategies for functional delayed gastric emptying in 1243 patients with distal gastric cancer

et al. 2020

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Background Analysis of the risk factors associated with functional delayed gastric emptying after distal gastric cancer surgery to provide a basis for further reduction of the incidence of this complication. Methods Total of 1382 patients with distal gastric cancer from January 2016 to October 2018 were enrolled. Correlation analysis was performed in 53 patients with FDGE by logistic regression. Subgroup risk analysis was performed in 114 patients with preoperative pyloric obstruction. A Pearson Chi-square analysis was used to compare categorical variables between normal distribution groups. Meanwhile, a t test was used to compare continuous variables between groups. Odds ratio (OR) was used for comparison of the two groups, and it was summarized with its 95% confidence interval (CI) and p value using logistic regression. Result In multivariable analysis, age (OR 1.081, 95% CI, 1.047–1.117), BMI (OR 1.233, 95% CI, 1.116–1.363), preoperative pyloric obstruction (OR 3.831, 95% CI, 1.829–8.023), smaller volume of residual stomach (OR 1.838, 95% CI, 1.325–6.080), and anastomosis in greater curvature perpendicular (OR 3.385, 95% CI, 1.632–7.019) and in greater curvature parallel (OR 2.375, 95% CI, 0.963–5.861) were independent risk factors of FDGE. In the preoperative pyloric obstruction group, higher BMI (OR 1.309, 95% CI, 1.086–1.579) and preoperative obstruction time (OR 1.054, 95% CI, 1.003–1.108) were independent risk factors of FDGE and preoperative gastrointestinal decompression (OR 0.231, 95% CI, 0.068–0.785) was independent protective factor of FDGE. Conclusion Adequate gastrointestinal decompression should be performed before the operation to reduce the incidence of postoperative gastroparesis in patients with preoperative pyloric obstruction. We also could improve the surgical methods to reduce the occurrence of FDGE, such as controlling the size of the residual stomach, ensuring blood supply. Especially selecting an appropriate stapler and anastomosis during the anastomosis process, the occurrence of FDGE can be reduced.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Analysis of risk factors and prevention strategies for functional delayed gastric emptying in 1243 patients with distal gastric cancer

et al. 2020

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“…The proband had undergone distal subtotal gastrectomy, but the many years that had elapsed since the surgery excluded the probability of it being a principal cause of his gastroparesis. Most cases of postsurgical gastroparesis thus occur within 1 year after surgery, with its occurrence after several years being rare [4]. Chemotherapy-induced gastroparesis has been recognized as a rare complication of high-dose chemotherapy such as myeloablative regimens prior to bone marrow transplantation in patients with blood cancers [5,6].…”

Section: Discussionmentioning

confidence: 99%

Gastroparesis as a significant gastrointestinal adverse event during intensive chemotherapy for solid cancer

Nakayama

Haratani

Kurosaki

et al. 2021

Preprint

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Proper management of chemotherapy-related gastrointestinal toxicities is essential to maximize therapeutic outcome for malignancies. Gastroparesis is characterized by delayed gastric emptying without gastrointestinal obstruction. Although it has not been well recognized as a complication of chemotherapy for solid malignancies, we here report a case of gastroparesis apparently due to neurotoxicity of high-intensity taxane- and platinum-based chemotherapy for a solid tumor. The patient experienced late-onset gastric dysmotility as evidenced by an abnormally dilated stomach even after cessation of feeding for several days. The gastroparesis was successfully controlled with a 5-HT4 receptor agonist, resulting in recovery of gastric motility and allowing completion of curative anticancer treatment. Despite its rarity in patients with solid cancers, gastroparesis should be recognized as a potential cause of persistent upper abdominal symptoms during neurotoxic chemotherapy in such individuals, given that a delay in its management may be detrimental to survival outcome.

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“…"Normal GE" was defined as GE T ½ < 72 minutes, "mild delayed GE" as GE T ½ ≥ 72 to < 144 minutes, and "marked delayed GE" as GE T ½ > 144 minutes. 11,12 We collected demographic data for enrolled patients when they underwent GES. Definitions of comorbid conditions were as follows; hypertension (≥ 140/90 mmHg or antihypertensive drugs), dyslipidemia (serum total cholesterol level ≥ 6.22 mmol/ L, serum low-density lipoprotein cholesterol level ≥ 4.14 mmol/ L, serum triglycerides level ≥ 2.27 mmol/L, serum high-density lipoprotein cholesterol level < 1.04 mmol/L or taking the lipidregulating drugs), 13 chronic kidney disease (serum creatinine level > 133 mmol/L in men and serum creatinine level > 106 mmol/ l in women) in study subjects.…”

Section: Methodsmentioning

confidence: 99%

Association Between Gastric Emptying Time and Incidence of Cardiovascular Diseases in Subjects With Diabetes

Park

Chung

et al. 2019

J Neurogastroenterol Motil

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Background/Aims Delayed gastric emptying (GE) is associated with high morbidity and mortality in subjects with diabetes. The aim of this study is to investigate associations between GE time and the major cardiovascular events (coronary heart diseases and ischemic stroke) in diabetic subjects with upper gastrointestinal (UGI) symptoms. Methods Among 259 subjects with chronic UGI symptoms who underwent gastric emptying study (GES) over 13 years, 122 diabetic subjects without gastric surgery and/or rapid GE were enrolled in this study. We also gathered data about baseline demographics, clinical characteristics, estimated GE half-time (GE T ½) and incidence of cardiovascular events following GES. Results The mean age of subjects was 64.0 ± 17.4 years. There were 86 women and 104 subjects with type 2 diabetes. There were 52 (42.6%) subjects with normal GE, 50 (41.0.%) subjects with mild delayed GE, and 20 (16.4%) subjects with marked delayed GE. During follow-up (median, 207 weeks), cardiovascular events occurred in 7 (13.5%) subjects with normal GE, 4 (8.0%) subjects with mild delayed GE and 7 (35.0%) subjects with marked GE (P = 0.015). Univariate analysis showed that GE T ½ was significantly associated with incidence of cardiovascular events (crude OR, 1.74; 95% CI, 1.12-2.69; P = 0.014). In a multivariate model, association between GE T ½ and incidence of cardiovascular events remained statistically significant after adjustment for baseline characteristics and comorbidities (adjusted OR, 1.94; 95% CI, 1.21-3.12; P = 0.006). Conclusion A delay of GE was associated with an increased incidence of cardiovascular events in diabetic subjects with chronic UGI symptoms.

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Clinical features of gastric emptying after distal gastrectomy

Cited by 16 publications

References 13 publications

Analysis of risk factors and prevention strategies for functional delayed gastric emptying in 1243 patients with distal gastric cancer

Analysis of risk factors and prevention strategies for functional delayed gastric emptying in 1243 patients with distal gastric cancer

Gastroparesis as a significant gastrointestinal adverse event during intensive chemotherapy for solid cancer

Association Between Gastric Emptying Time and Incidence of Cardiovascular Diseases in Subjects With Diabetes

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