{"title":"食管内压力对全胃切除术后患者生活质量影响的探索性研究:一项回顾性队列研究","authors":"Yoshihiro Saeki, Kazuaki Tanabe, Hiroshi Ota, Emi Chikuie, Yuki Takemoto, Nozomi Karakuchi, Akihiro Kohata, Osamu Miura, Eiichiro Toyama, Naruji Kugimiya, Hideki Ohdan","doi":"10.1186/s12893-024-02504-1","DOIUrl":null,"url":null,"abstract":"The usefulness of high-resolution impedance manometry (HRIM) in patients who underwent total gastrectomy with Roux-en-Y (R-Y) anastomosis has never been well validated. This study aimed to investigate whether intraesophageal pressure affects quality of life in patients who underwent total gastrectomy with R-Y anastomosis. The participants comprised 12 patients who underwent total gastrectomy for gastric cancer between October 2014 and July 2022 and underwent a postsurgical HRIM examination. The association between the HRIM data and Postgastrectomy Syndrome Assessment Scale-37 (PGSAS-37) questionnaires was analyzed. Esophageal body motility was normal in almost all patients. The anastomosis shape (circular stapler and overlap method with linear stapler) did not influence intraesophageal pressure. The integrated relaxation pressure and lower esophageal sphincter (LES) residual pressure during swallowing-induced relaxation were involved in “diarrhea subscale” scores (p = 0.0244 and p = 0.0244, respectively). The average maximum intrabolus pressure was not involved in postgastrectomy symptom. The contractile front velocity correlated with the “indigestion subscale,” “diarrhea subscale,” and “constipation subscale” (p = 0.0408, p = 0.0143, and p = 0.0060, respectively). The distal latency, i.e., the time from upper esophageal sphincter relaxation to contractile deceleration, was also associated with the “abdominal pain subscale” (p = 0.0399). LES pressure and esophageal body motility affected patients’ quality of life after total gastrectomy. HRIM for the evaluation of intraesophageal pressure is useful for the functional assessment of esophagojejunostomy with the R-Y reconstruction after total gastrectomy.","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Exploratory study on the impact of intraesophageal pressure on quality of life in patients following total gastrectomy: a retrospective cohort study\",\"authors\":\"Yoshihiro Saeki, Kazuaki Tanabe, Hiroshi Ota, Emi Chikuie, Yuki Takemoto, Nozomi Karakuchi, Akihiro Kohata, Osamu Miura, Eiichiro Toyama, Naruji Kugimiya, Hideki Ohdan\",\"doi\":\"10.1186/s12893-024-02504-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"The usefulness of high-resolution impedance manometry (HRIM) in patients who underwent total gastrectomy with Roux-en-Y (R-Y) anastomosis has never been well validated. This study aimed to investigate whether intraesophageal pressure affects quality of life in patients who underwent total gastrectomy with R-Y anastomosis. The participants comprised 12 patients who underwent total gastrectomy for gastric cancer between October 2014 and July 2022 and underwent a postsurgical HRIM examination. The association between the HRIM data and Postgastrectomy Syndrome Assessment Scale-37 (PGSAS-37) questionnaires was analyzed. Esophageal body motility was normal in almost all patients. The anastomosis shape (circular stapler and overlap method with linear stapler) did not influence intraesophageal pressure. The integrated relaxation pressure and lower esophageal sphincter (LES) residual pressure during swallowing-induced relaxation were involved in “diarrhea subscale” scores (p = 0.0244 and p = 0.0244, respectively). The average maximum intrabolus pressure was not involved in postgastrectomy symptom. The contractile front velocity correlated with the “indigestion subscale,” “diarrhea subscale,” and “constipation subscale” (p = 0.0408, p = 0.0143, and p = 0.0060, respectively). The distal latency, i.e., the time from upper esophageal sphincter relaxation to contractile deceleration, was also associated with the “abdominal pain subscale” (p = 0.0399). LES pressure and esophageal body motility affected patients’ quality of life after total gastrectomy. HRIM for the evaluation of intraesophageal pressure is useful for the functional assessment of esophagojejunostomy with the R-Y reconstruction after total gastrectomy.\",\"PeriodicalId\":49229,\"journal\":{\"name\":\"BMC Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-07-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12893-024-02504-1\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12893-024-02504-1","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
高分辨率阻抗测压法(HRIM)对接受全胃切除术并行 Roux-en-Y (R-Y)吻合术的患者的作用尚未得到充分验证。本研究旨在调查食道内压是否会影响接受 R-Y 吻合术的全胃切除术患者的生活质量。参与者包括2014年10月至2022年7月期间因胃癌接受全胃切除术并接受术后HRIM检查的12名患者。研究人员分析了HRIM数据与胃切除术后综合征评估量表-37(PGSAS-37)问卷之间的关联。几乎所有患者的食管体运动均正常。吻合口形状(圆形订书机和线性订书机重叠法)对食管内压没有影响。吞咽诱导松弛时的综合松弛压力和下食管括约肌(LES)残余压力与 "腹泻量表 "评分有关(分别为 p = 0.0244 和 p = 0.0244)。平均最大胃内压力与胃切除术后症状无关。收缩前速度与 "消化不良分量表"、"腹泻分量表 "和 "便秘分量表 "相关(分别为 p = 0.0408、p = 0.0143 和 p = 0.0060)。远端潜伏期,即食管上括约肌从松弛到收缩减速的时间,也与 "腹痛分量表 "相关(p = 0.0399)。LES 压力和食管体运动影响全胃切除术后患者的生活质量。评估食管内压的 HRIM 可用于全胃切除术后食管空肠吻合术与 R-Y 重建的功能评估。
Exploratory study on the impact of intraesophageal pressure on quality of life in patients following total gastrectomy: a retrospective cohort study
The usefulness of high-resolution impedance manometry (HRIM) in patients who underwent total gastrectomy with Roux-en-Y (R-Y) anastomosis has never been well validated. This study aimed to investigate whether intraesophageal pressure affects quality of life in patients who underwent total gastrectomy with R-Y anastomosis. The participants comprised 12 patients who underwent total gastrectomy for gastric cancer between October 2014 and July 2022 and underwent a postsurgical HRIM examination. The association between the HRIM data and Postgastrectomy Syndrome Assessment Scale-37 (PGSAS-37) questionnaires was analyzed. Esophageal body motility was normal in almost all patients. The anastomosis shape (circular stapler and overlap method with linear stapler) did not influence intraesophageal pressure. The integrated relaxation pressure and lower esophageal sphincter (LES) residual pressure during swallowing-induced relaxation were involved in “diarrhea subscale” scores (p = 0.0244 and p = 0.0244, respectively). The average maximum intrabolus pressure was not involved in postgastrectomy symptom. The contractile front velocity correlated with the “indigestion subscale,” “diarrhea subscale,” and “constipation subscale” (p = 0.0408, p = 0.0143, and p = 0.0060, respectively). The distal latency, i.e., the time from upper esophageal sphincter relaxation to contractile deceleration, was also associated with the “abdominal pain subscale” (p = 0.0399). LES pressure and esophageal body motility affected patients’ quality of life after total gastrectomy. HRIM for the evaluation of intraesophageal pressure is useful for the functional assessment of esophagojejunostomy with the R-Y reconstruction after total gastrectomy.