| Nutritional comparisons between a pylorus-preserving gastrectomy with and without suprapyloric lymph node clearance: a preliminary report. | |
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MedLine Citation:
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PMID: 18265675 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND/AIMS: A pylorus-preserving gastrectomy (PPG) is a procedure for gastric cancer (GC) patients which attempts to control gastric emptying and to minimize postoperative nutritional disadvantages. The persistence of conflicting stances concerning qualifying candidates for PPG--a narrower or wider segment of patients--is attributable to a lack of decisive evidence concerning the precise nutritional impact of suprapyloric lymph node clearance. METHODOLOGY: Forty-eight patients underwent a PPG with (30 patients; dissection group) or without (18 patients; preservation group) suprapyloric lymph node clearance between 2002 and 2004. Patients with mucosal GC located in the middle third of the stomach were assigned to the preservation group and the other early GC patients formed the dissection group. Those who were followed up more than one year postoperatively were selected from the preservation (8 patients) and the dissection (16 patients) groups, and changes in body weight, hemoglobin, total protein, and albumin were compared between the two groups. Baseline clinicopathological characteristics, surgically related events, and supportive medications were also compared between the two groups. RESULTS: Dissection group patients received significantly longer surgery (p < 0.01) and a wider scope of lymphadenectomy (p < 0.0001) than preservation group patients. Other factors including the length of postoperative hospital stay and morbidity rate did not differ between the two groups. Percent changes in body weight, hemoglobin, total protein, and albumin, as well as postoperative profiles of each parameter were similar between the two groups. CONCLUSIONS: These results suggest that suprapyloric lymph node clearance resulted in more traumatic surgery while it did not exacerbate postoperative nutritional status as compared with suprapyloric lymph node preservation. PPG is justifiable for submucosal GC or an even wider segment of patients by suprapyloric lymph node clearance without nullifying the anticipated nutritional benefit. |
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Authors:
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Shouji Shimoyama; Kazuhiro Imamura; Naoki Hiki; Nobuyuki Shimizu; Hirokazu Yamaguchi; Ken-Ichi Mafune; Michio Kaminishi |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Hepato-gastroenterology Volume: 54 ISSN: 0172-6390 ISO Abbreviation: Hepatogastroenterology Publication Date: 2007 Dec |
Date Detail:
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Created Date: 2008-02-12 Completed Date: 2008-03-21 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8007849 Medline TA: Hepatogastroenterology Country: Greece |
Other Details:
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Languages: eng Pagination: 2401-5 Citation Subset: IM |
Affiliation:
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Department of Gastrointestinal Surgery, University of Tokyo, Tokyo, Japan. shimoyama@apost.plala.or.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Female Gastrectomy / methods* Gastric Mucosa / pathology Humans Length of Stay Lymph Node Excision* Male Middle Aged Nutritional Status* Postoperative Period Pylorus / physiology Stomach Neoplasms / surgery* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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