| Project/Area Number |
16591361
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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 | Nippon Medical School |
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Principal Investigator |
KIYAMA Teruo Nippon Medical School, Department of Medicine, Assistant Professor, 医学部, 講師 (30246954)
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| Co-Investigator(Kenkyū-buntansha) |
KAMEGAI Jun Nippon Medical School, Department of Medicine, Special Research Fellow, 医学部, 特別研究生 (20204638)
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| Project Period (FY) |
2004 – 2005
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| Project Status |
Completed (Fiscal Year 2005)
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| Budget Amount *help |
¥3,500,000 (Direct Cost: ¥3,500,000)
Fiscal Year 2005: ¥1,500,000 (Direct Cost: ¥1,500,000)
Fiscal Year 2004: ¥2,000,000 (Direct Cost: ¥2,000,000)
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| Keywords | gastrectomy / body composition / ghrelin / appetite / decrease of body fat |
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| Research Abstract |
Ghrelin, which is mainly produced in gastric fundic gland, is one of the gastrointestinal hormones and stimulates appetite. Gastric fundic gland is located in the upper third of the stomach. So, proximal gastrectomy should be limited less than half of stomach due to reservation of stomach function. The aim of this study was to compare changes in serum ghrelin level and the body composition of patients undergoing proximal gastrectomy (PG), distal gastrectomy (DG), or total gastrectomy (TG).
Patients and Methods : Gastric surgery was performed in the Nippon Medical School Hospital between 2003 and 2004 in 135 patients who had undergone PG (12), DG (70), and TG (53). Laparoscopy assisted proximal gastrectomy was reconstructed by esophago-residual stomach anastomosis (10) and double tract method (2). Changes in serum levels of ghrelin and the body composition were evaluated preoperatively, on postoperative day 14, and 1 year after surgery.
Results : Operation time was 306 min in PG and 270 min in DG. Blood loss was 164g in PG and 124g in DG. Postoperative hospital stay was 10.4 days in PG and 10.1 days in DG. There was no difference between the two groups. Serum ghrelin level 6 months after surgery was 42±18fmol/ml in PG less than 67+37fmol/ml in DG (p<0.05). Body weight loss was 6.5±2.5kg in PG higher than 3.0±2.0 in DG (p<0.05). The fat composition (4.8±3.0kg) was decreased mainly in PG.
Conclusion : Laparoscopy assisted gastrectomy caused early recover from surgical insults and the indication of LAG was expanded. Serum ghrelin was decreased after PG but higher than TG. Body weight loss after PG was higher than DG but less than TG. These results suggest that PG remains more than half volume of stomach which should maintain endocrine function and body weight. Further study should be necessary that preservation of the celiac branches of the vagus nerve might maintain gastric function, such as appetite, after gastrectomy.
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