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Assessment of Motor Function of the Remnant Stomach by 13C Breath Test With Special Reference to Gastric Local Resection

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Abstract

Background

Indications for gastric local resection (LR) include gastrointestinal stromal tumors, neuroendocrine tumors, and early gastric cancer. LR is expected to preserve physiological function and ameliorate postgastrectomy syndrome.

Methods

Gastric emptying was assessed by the 13C-acetate breath test in 20 healthy volunteers (HVs) and 60 gastrectomized patients [distal gastrectomy with Billroth I reconstruction (DGBI) in 26 patients, LR in 34 patients]. For the 13C breath test, 100 mg of 13C-acetate sodium salt was mixed in a test meal. Breath samples were collected before intake and during the next 3 h. We compared the gastric reservoir capacity using the gastric retention rate at 5 min (RR5) and gastric emptying by the half emptying time (T½). Patients completed a questionnaire survey about their symptoms, dietary intake, body weight, and restriction of activities of daily living [reflecting quality of life (QOL)].

Results

The RR5 values for the HV, LR, and DGBI groups were 93.7, 90.0, and 45.3* %, respectively (*compared to HV and LR, p < 0.0001). The T½ values were 23.3, 20.2, and 5.9* min, respectively. Dietary intake and body weight change were significantly more reduced in the DGBI group than the LR group (p < 0.05). Subgroup analysis indicated that the reservoir capacity in those with LR at the lesser curvature was more disturbed than that in patients with LR at the greater curvature. The questionnaire showed no differences in those patients’ QOL.

Conclusions

Because the reservoir capacity, the gastric emptying and QOL were maintained, LR is an option for selected patients with early gastric cancer.

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Acknowledgments

This study was supported by a grant from MEXT (Ministry of Education, Culture, Sports, Science and Technology)-Supported Program for the Strategic Research Foundation at Private Universities, (2011–2013). The authors thank all the patients whose cooperation made this study possible.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan

    Masahiko Kawamura, Koji Nakada, Hideo Konishi, Taizo Iwasaki, Keishiro Murakami, Norio Mitsumori, Nobuyoshi Hanyu, Nobuo Omura & Katsuhiko Yanaga

Authors
  1. Masahiko Kawamura
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  2. Koji Nakada
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  3. Hideo Konishi
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  4. Taizo Iwasaki
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  5. Keishiro Murakami
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  6. Norio Mitsumori
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  7. Nobuyoshi Hanyu
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  8. Nobuo Omura
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  9. Katsuhiko Yanaga
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Corresponding author

Correspondence to Masahiko Kawamura.

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Kawamura, M., Nakada, K., Konishi, H. et al. Assessment of Motor Function of the Remnant Stomach by 13C Breath Test With Special Reference to Gastric Local Resection. World J Surg 38, 2898–2903 (2014). https://doi.org/10.1007/s00268-014-2660-6

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  • DOI: https://doi.org/10.1007/s00268-014-2660-6

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