Preliminary prospective study of real-time post-gastrectomy glycemic fluctuations during dumping symptoms using continuous glucose monitoring  

作　　者：Motonari Ri Souya Nunobe Satoshi Ida Naoki Ishizuka Shinichiro Atsumi Rie Makuuchi Koshi Kumagai Manabu Ohashi Takeshi Sano 

机构地区：[1]Department of Gastroenterological Surgery,Cancer Institute Hospital,Japanese Foundation for Cancer Research,Tokyo 135-8550,Japan [2]Clinical Trial Planning and Management,Cancer Institute Hospital,Japanese Foundation for Cancer Research,Tokyo 135-8550,Japan

出　　处：《World Journal of Gastroenterology》2021年第23期3386-3395,共10页世界胃肠病学杂志（英文版）

摘　　要：BACKGROUND Although dumping symptoms constitute the most common post-gastrectomy syndromes impairing patient quality of life,the causes,including blood sugar fluctuations,are difficult to elucidate due to limitations in examining dumping symptoms as they occur.AIM To investigate relationships between glucose fluctuations and the occurrence of dumping symptoms in patients undergoing gastrectomy for gastric cancer.METHODS Patients receiving distal gastrectomy with Billroth-I(DG-BI)or Roux-en-Y reconstruction(DG-RY)and total gastrectomy with RY(TG-RY)for gastric cancer(March 2018-January 2020)were prospectively enrolled.Interstitial tissue glycemic profiles were measured every 15 min,up to 14 d,by continuous glucose monitoring.Dumping episodes were recorded on 5 patient-selected days by diary.Within 3 h postprandially,dumping-associated glycemic changes were defined as a dumping profile,those without symptoms as a control profile.These profiles were compared.RESULTS Thirty patients were enrolled(10 DG-BI,10 DG-RY,10 TG-RY).The 47 early dumping profiles of DG-BI showed immediately sharp rises after a meal,which 47 control profiles did not(P<0.05).Curves of the 15 late dumping profiles of DG-BI were similar to those of early dumping profiles,with lower glycemic levels.DGRY and TG-RY late dumping profiles(7 and 13,respectively)showed rapid glycemic decreases from a high glycemic state postprandially to hypoglycemia,with a steeper drop in TG-RY than in DG-RY.CONCLUSION Postprandial glycemic changes suggest dumping symptoms after standard gastrectomy for gastric cancer.Furthermore,glycemic profiles during dumping may differ depending on reconstruction methods after gastrectomy.

关 键 词：Gastric cancer GASTRECTOMY Billroth-I reconstruction Roux-en-Y reconstruction Dumping syndrome Continuous glucose monitoring 

分 类 号：R656.61[医药卫生—外科学]