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Differences in glycemic trends due to reconstruction methods after proximal gastrectomy from the perspective of continuous glucose-monitoring

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Abstract

Purpose

In recent years, clinicians have focused on the importance of preventing hypoglycemia. We evaluated the impact of different reconstruction procedures after proximal gastrectomy on glycemic variability in non-diabetic patients with gastric cancer.

Methods

This prospective observational study was conducted between April 2020 and March 2023. Flash continuous glucose-monitoring, a novel method for assessing glycemic control, was used to evaluate the glycemic profiles after gastrectomy. A flash continuous glucose-monitoring sensor was placed subcutaneously at the time of discharge, and glucose trends were evaluated for 2 weeks.

Results

The anastomotic methods for proximal gastrectomy were esophagogastrostomy in 10 patients and double-tract reconstruction in 10 patients. The time below this range (glucose levels < 70 mg/dL) was significantly higher in the double-tract reconstruction group than in the esophagogastrostomy group (p = 0.049). A higher nocturnal time below this range was significantly correlated with an older age and double-tract reconstruction (p = 0.025 and p = 0.025, respectively).

Conclusion

These findings provide new insights into reconstruction methods after proximal gastrectomy by assessing postoperative hypoglycemia in non-diabetic patients with gastric cancer.

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Acknowledgements

We express our deepest gratitude to Prof. Eigo Otsuji for helping with the launch of this project. We also thank the staff at the University of Yamanashi Hospital for their efforts in data entry.

Funding

This study was partially supported by the Japan Society for the Promotion of Science KAKENHI (grant number 21K16442).

Author information

Authors and Affiliations

  1. First Department of Surgery, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 4093898, Japan

    Katsutoshi Shoda, Yoshihiko Kawaguchi, Hidenori Akaike, Suguru Maruyama, Yudai Higuchi, Takashi Nakayama, Ryo Saito, Koichi Takiguchi, Shinji Furuya, Kensuke Shiraishi, Hidetake Amemiya, Hiromichi Kawaida & Daisuke Ichikawa

  2. Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 6028566, Japan

    Takeshi Kubota

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  1. Katsutoshi Shoda
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Contributions

Conceptualization: Katsutoshi Shoda and Takeshi Kubota; Methodology: Katsutoshi Shoda and Takeshi Kubota; Formal analysis and investigation: Katsutoshi Shoda, Yoshihiko Kawaguchi, Hidenori Akaike, and Suguru Maruyama; Writing (original draft preparation): Katsutoshi Shoda; Writing (review and editing): Yudai Higuchi, Takashi Nakayama, Koichi Takiguchi, Ryo Saito, Suguru Maruyama, Shinji Furuya, Kensuke Shiraishi, Hidetake Amemiya, and Hiromichi Kawaida; Supervision: Daisuke Ichikawa.

Corresponding author

Correspondence to Katsutoshi Shoda.

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Ethics approval

Daisuke Ichikawa is currently an Editor or Editorial Board Member of Annals of Gastroenterological Surgery. The authors declare that they have no conflicts of interest. This study conformed to the ethical guidelines of the Declaration of Helsinki of the World Medical Association Declaration. Helsinki. All patients provided their written informed consent for surgery, and Institutional Review Board approval was obtained from Yamanashi University (approval number 2350).

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Shoda, K., Kubota, T., Kawaguchi, Y. et al. Differences in glycemic trends due to reconstruction methods after proximal gastrectomy from the perspective of continuous glucose-monitoring. Surg Today (2024). https://doi.org/10.1007/s00595-024-02845-7

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