Gastric emptying after segmental gastrectomy for early cancer in the middle part of the stomach

BACKGROUND/AIMS: We evaluated the quality of life and gastric emptying in p atients who had undergone a segmental gastrectomy to treat early gastric ca ncer in the middle part of the stomach. METHODOLOGY: Thirty patients were considered in this study. Their mean age was 65.5 years (range: 44-83). All of the patients were free from recurrenc e of their cancer in the follow-up period. This ranged from 5 to 50 months (mean 30). Patients were interviewed at regular intervals to assess their q uality of life and to note particular complaints. The upper gastrointestina l tract was assessed endoscopically. A gastric emptying study was performed at 3, 6, and 12 months after surgery. The meal used in this dual-phase stu dy had solid and liquid phases. For the solid phase, 74MBq of Tc-99m sulfur colloid was injected into an egg, which was then hard-boiled. For the liqu id phase, 18.5MBq of In-111-diethyltriaminopenta acetic acid (DTPA) were mi xed into 150ml of a commercial, elentary liquid diet. RESULTS: Three months after surgery, the patients' main complaints were gas tric stasis (25%), heartburn (8%) and belching (8%). The patients gradually became asymptomatic following surgery. Fifty-nine percent were asymptomati c at the 5-month follow-up, 84% at 6 months, and 92% at 12 months. There wa s no evidence of reflux esophagitis or gastritis after the 3-month follow-u p. One patient developed a complicated duodenal ulcer. Initially, the patie nts all had prolonged gastric emptying of the dual phase meal, compared to normal individuals. The T1/2 for liquid meal emptying was 87+/-18min at 3 m onths, 77+/-20min at 6 months and 50+/-5min at 1 year after surgery. The la st value is the same as for healthy individuals. Solid meal emptying was st ill prolonged, with an emptying rate of 36+/-97% at 2 hours, one year after surgery. CONCLUSIONS: Segmental gastrectomy patients experienced prolonged gastric e mptying in the early post-operative period. This improved in the first year after surgery. The quality of life for patients who underwent segmental ga strectomy has been reasonably good in the follow-up period to date.