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Objective To compare the clinical efficacy of DSA-guided pyloric balloon dilation with that of conservative medical treatment for postsurgical gastroparesis syndrome(PGS).Methods The clinical data of 41 patients with PGS,who were admitted to the Department of Interventional Radiology,Affiliated Third Hospital of Suzhou University of China to receive DSA-guided pyloric balloon dilation(study group,n=21)or conservative medical treatment(control group,n=20)between January 2012 and February 2021,were retrospectively analyzed.The median follow-up period in the control group and the study group was 626 days and 588 days respectively.The average length of stay(ALOS)was compared between the two groups.Results In the study group,all the 21 patients returned to normal food intake within 2 days after successful DSA-guided pyloric balloon dilation treatment,and they were all discharged within one week after treatment.The ALOS in the study group was(10.2±1.3)days,which was strikingly shorter than(34.5±14.2)days in the control group,the difference between the two groups was statistically significant(P＜0.001).Conclusion For the treatment of PGS,DSA-guided pyloric balloon dilation carries better clinical efficacy when compared with conservative medical treatment,therefore,it can be used as the preferred treatment for patients with PGS.Further studies are need to be conducted before its therapeutic mechanism can be clarified.
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Objective To investigate the influencing factors of postoperative gastroparesis syndrome(PSG)after laparoscopic right hemicolon cancer resection.Methods A total of 1070 patients with laparoscopic right hemicolon cancer resection(complete right hemicolon mesoresection)were selected from Wuhan General Hospital of Yangtze River Shipping and Wuhan Union Hospital Cancer Department from December 2012 to June 2022.According to whether the patients got postoperative gastroparesis,were divided into the postoperative gastroparesis syndrome(PSG)group or the normal control group.Univariate and multivariate Logistic regression analysis were used to analyze the risk factors of PGS after right hemicolon resection.Results There were 29 patients in the gastroparesis group and 1041 patients in the normal control group.Univariate analysis showed that age,perioperative blood glucose level,surgical resection range,and surgical approach were related to the occurrence of PGS(P＜0.05).Multivariate Logistic analysis showed that age,high perioperative blood glucose level,caudal approach plus combined approach,and large surgical resection range were independent influencing factors of PGS(P＜0.05).Conclusions Age,high perioperative blood glucose level,caudal approach plus combined approach,and large surgical resection range are influencing factors of PGS.
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Objective: To investigate the reasons for the occurrence of postsurgical gastroparesis syndrome (PGS) in the patients with gastric cancer after gastric cancer operation, and to elucidate the related risk factors and treatment measures for the PGS patients, and to provide the basis for improving the quality of life of the patients with PGS. Methods: The clinical data of 1 015 patients underwent radical gastrectomy were retrospectively analyzed and the patients were divided into PGS group (n=39) and non-PGS group ("=976) according to whether the PGS appeared after operation. Single factor analysis was performed according to age, gender, surgical method and anastomosis in the patients in two groups. The risk factors related to PGS were analyzed. Results, There was no difference in the incidence of PGS in the patients ≥56 years old and the patients 0. 05), the incidence of PGS in the male patients was not significantly different from that in the female patients (P>0. 05); the incidence of PGS in the patients underwemt radical gastrectomy was higher than that in the patients underwent laparoscopic radical gastrectomy (P<0. 01), the incidence of PGS in the patients underwent Billroth I anastomosis was lower than that in the patients underwent Billroth II anastomosis (P<0. 01). All the PGS patients were cured after treated with a combination method of drugs and p sychology. Conclusion: The occurrence of PGS after radical gastrectomy has nothing to do with the physiological factors of the patients such as gender and age. The incidence of PGS after laparoscopic radical gastrectomy is lower than that after open radical gastrectomy, and the incidence of PGS after Billroth I anastomosis is lower than that after Billroth II anastomosis.
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Objective@#To investigate the safety and efficacy of the Weitan Waifu patch on the postsurgical gastroparesis syndrome (PGS) of gastrointestinal cancer.@*Methods@#The multi-center, double-blind, randomized controlled trial was conducted with superiority design. Patients with PGS of gastrointestinal cancer diagnosed in 4 AAA hospitals and the abdominal symptom manifested as cold syndrome by Chinese local syndrome differentiation were recruited. These patients were randomly divided into two groups according to 1∶1 proportion. Placebo or Weitan Waifu patch was applied in control group or intervention group, respectively, based on the basic treatments, including nutrition support, gastrointestinal decompression, promoting gastric dynamics medicine.Two acupuncture points (Zhongwan and Shenque) were stuck with placebo in control group or patch in treatment group. The intervention course was 14 days or reached the effective standard.@*Results@#From July 15, 2013 to Jun 3, 2015, 128 participants were recruited and 120 eligible cases were included in the full analysis set (FAS), and 60 cases in each group. 88 cases were included in the per-protocol set (PPS), including 45 cases in the treatment group and 43 cases in the control group. In the FAS, the clinical effective rate in the treatment group was 68.3%, significantly superior than 41.7% of the control group (P=0.003). The medium time of effective therapy in the treatment group was 8 days, significantly shorter than 10 days in the control group (P=0.017). In the FAS, 3 adverse events occurred in the treatment group, including mild to moderate decrustation, pruritus and nausea. The incidence rate of adverse events was 5.0% (3/60) and these symptoms were spontaneously remitted after drug withdrawal. No severe adverse events were observed in the control group. There was no significant difference between these two groups (P=0.244).@*Conclusion@#Weitan Waifu patch is a safely and effectively therapeutic method for patients with PGS (cold syndrome) of gastroenterological cancer.@*Trial registration@#International Standard Randomized Controlled Trial Number Register, ISRCTN18291857
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Objective To study the effect of mental intervention on patients with postsurgical gastroparesis syndrome (PGS). Methods 70 patients with gastroptroparesis syndrome after abdominal operation were divided into the control group and the experimental group with 35 patients in each group according to chronological order.The patients in the control group accepted routine care,and the experimental group was given mental intervention based on routine care.Center for Epidemiological Survey Depression Scale (CESD) was used to evaluated the emotional state before and after intervention.Besides,the recovery of gastrointestinal function was appraised. Results The improvement level of anxiety in the experimental group was higher than the control group.The extinction time of symptoms,indwelling time of gastric tube,recovery time of food intake were shorter than the control group.Drainage time when gastric juice ＞ 800ml/d was shorter,recovery time of PGS and hospitalization time were shorter,the treatment cost was reduced,compared with the control group. Conclusions Mental intervention can alleviate the negative emotion and shorten the recovery time of patients with postsurgical gastroparesis syndrome.
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Objective To summarize the clinical features,diagnosis and treatment principles of abdomen postsurgical gastroparesis syndrome(PGS).Methods The clinical data of 28 patients with abdomen postsurgical gastroparesis syndrome,collected from our hospital in the past ten years,were analyzed retrospectively.Results All 28 patients were cured by conservation therapy.The average gastric dynamics response time was 20.2 days(12.0～34.0 days),which included 2 cases recovered within 1-2 weeks,17 cases recovered within 2-3 weeks,7 cases recovered within 3-4 weeks,2 cases recovered over 4 weeks.Conclusion PGS is a functional reaction rather than mechanical obstruction disease.The diagnosis mainly depends on the symptoms and sighs combined with gastrointestinal angiography or endoscopy.Most of the patients can be cured by conservative treatment.
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Objective To explore the etiology,diagnosis and treatment of postsurgical gastroparesis syndrome(PGS)after radical gastrectomy for gastric carcinoma.Methods The data of 585 patients who had undergone radical gastrectomy for gastric carcinoma were retrospectively studied.The diagnosis was established with fiberoptic gastroscopy and biopsy before operation in all the patients,and radical subtotal gastrectomy was performed,with antero-colonic Billroth's Ⅱ anastomosis of the remnant stomach and jejunum.Results PGS occurred in 24 patients(age 46-81,mean 58.6 years)among 585 patients,the prevalence was 4.1%.In all the 24 patients,PGS occurred at the period when liquid diet was changed to semifluid diet,with the symptoms of epigastric fullness,nausea,vomiting and intractable hiccup.The vomitus contained large amount of gastric contents and a small amount of bile.The quantity of gastrointestinal decompression was 800-2000 ml/d.Upper gastrointestinal radiography using 38% meglucamine diatrizoate was performed in all the 24 patients,the contrast agent was taken orally or through gastric tube.It showed that the remnant stomach was atonic,gastric peristalsis was weak or absent,and evacuation of contrast agent was delayed.The anastomosis stoma was patent.Gastroscopy was performed in 18 patients,and a large amount of residual gastric content and anatomotic edema of anastomosis stoma were found.Howener,the gastroscope could be introenced into the duodenum or jejunal efferent loop through anastomotic stoma without difficulty,and no signs of mechanical obstruction were found.All the 18 patients were cured within10-38 days by conservative treatment.Conclusion The main causes of PGS may be the loss of gastrointestinal motility and anastomotic edema,while the risk factors may include old age,malnutrition,water-electrolyte imbalance,and peritoneal infection.Gastrointestinal radiography and gastroscopy are important diagnostic methods,and the patients can be cured by conservative treatment.