Postoperative evaluation of pylorus-preserving procedures compared with conventional distal gastrectomy for early gastric cancer

We evaluated postoperative function in 98 patients who underwent surgery fo r early gastric cancer between 1995 and 1998 to compare the results of pylo rus-preserving procedures to those of conventional distal gastrectomy with Billroth I (B-I). The pylorus-preserving procedures included endoscopic muc osal resection (EMR), performed in 12 patients; local resection (Local), pe rformed in 14 patients; segmental resection (Seg), performed in 8 patients; and pylorus-preserving gastrectomy (PPG), performed in 19 patients. B-I wa s performed in 45 patients. The nutritional status and serum albumin (Alb) levels after PPG, the hemoglobin (Hb) levels after EMR, Local, and PPG, and the present/preoperative body weight ratios after EMR, Local, Seg, and PPG were superior to those after B-I. The time before oral intake was recommen ced after EMR and Local, the volume of oral intake tolerated after EMR, Loc al, Seg, and PPG, and the postoperative hospital stay after EMR were all su perior to those after B-I. Moreover, significantly fewer patients suffered reflux symptoms after EMR, Local, and PPG, abdominal fullness after EMR, an d early dumping syndrome after EMR, Local, and PPG than after B-I. There wa s also less evidence of gastritis after EMR, Local, and PPG, and of bile re flux after EMR, Local, and PPG, than after B-I. These findings indicate tha t pylorus-preserving procedures may result in a better postoperative qualit y of life for selected patients with early gastric cancer.