| Project/Area Number |
08671492
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Digestive surgery
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| Research Institution | Kansai Medical University |
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Principal Investigator |
NAKANE Yasushi Kansai Med.Univ., School of Medicine, Associate Professor, 医学部, 助教授 (60155778)
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| Co-Investigator(Kenkyū-buntansha) |
HIOKI Koshiro Kansai Med.Univ., School of Medicine, Professor, 医学部, 教授 (60077641)
OSAWA Tunehide Kansai Med.Univ., School of Medicine, Assistant, 医学部, 助手 (20199590)
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| Project Period (FY) |
1996 – 1998
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| Project Status |
Completed (Fiscal Year 1998)
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| Budget Amount *help |
¥2,300,000 (Direct Cost: ¥2,300,000)
Fiscal Year 1998: ¥200,000 (Direct Cost: ¥200,000)
Fiscal Year 1997: ¥1,200,000 (Direct Cost: ¥1,200,000)
Fiscal Year 1996: ¥900,000 (Direct Cost: ¥900,000)
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| Keywords | Total gastrectomy / Jejunal pouch / Reconstruction / Gastric cancer / 胃癌 / 空腸pouch再建術式 / quality of life / RIシンチグラム / 消化管外来神経切離 / 壁内神経叢(Auerbach神経叢) / 免疫組織染色 |
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| Research Abstract |
Based on the results of the fundamental study using rats, we modified the operative procedures used in pouch and interposition(PI) reconstruction in an attempt to improve the surgical results after total gastrectomy, because a randomized controlled trial had revealed that the clinical assessment of PI was quite poor, even though it is a physiological route. In most of the treated patients, the gastric emptying test revealed delayed emptying, and an X-ray video film showed folding and twisting of the jejunal conduit between the pouch and duodenum, which disturbed the transmission of nutrition. Modified PI (m-PI) was performed by decreasing the length of the jejunal conduit and widening the mesenteric pedicle to preserve the blood and nerve supply. This procedure was retrospectively compared with the previously used P1 reconstruction by evaluating the postprandial symptoms, food intake, body weight, serum nutritional parameters, and emptying time of the gastric substitute. The m-PI group (n=6) showed a lower incidence of symptoms, a greater food intake, and a greater weight recovery than the PI group (n=6). The gastric emptying test also revealed an acceptable degree of emptying. We thus conclude that the m-PI reconstruction is more useful for improving the postoperative quality of life than thepreviously used method of PI reconstruction.
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