• Journal of Gastric Cancer
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• v.20 no.3
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• pp.256-266
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• 2020

Purpose: This study aimed to examine the early postprandial changes in gastrointestinal (GI) hormones and hemodynamics in terms of early dumping syndrome after gastrectomy for gastric cancer. Materials and Methods: Forty patients who underwent gastrectomy for gastric cancer and 18 controls without previous abdominal surgery were enrolled. Before and 20 minutes after liquid meal ingestion, blood glucose, glucagon-like peptide-1 (GLP-1), and GLP-2 concentrations and superior mesenteric artery (SMA) and renal blood flow were measured. The patients' heart rates were recorded at 5-minute intervals. All subjects were examined for dumping syndrome using a questionnaire based on Sigstad's clinical diagnostic index. Results: The postprandial increases in blood glucose, GLP-1, and GLP-2 levels as well as SMA blood flow and heart rate were greater in patients who underwent gastrectomy than in controls (all P<0.010). Patients who underwent gastrectomy showed a significantly decreased renal blood flow (P<0.001). Among patients who underwent gastrectomy, distal gastrectomy was a significant clinical factor associated with a lower risk of early dumping syndrome than total gastrectomy (hazard ratio, 0.092; 95% confidence interval, 0.013-0.649; P=0.017). Patients who underwent total gastrectomy showed a greater postprandial increase in blood glucose (P<0.001), GLP-1 (P=0.030), and GLP-2 (P=0.002) levels as well as and heart rate (P=0.013) compared to those who underwent distal gastrectomy. Conclusions: Early postprandial changes in GI hormones and hemodynamics were greater in patients who underwent gastrectomy than in controls, especially after total gastrectomy, suggesting that these changes play a crucial role in the pathophysiology of early dumping syndrome.

• The Journal of Internal Korean Medicine
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• v.41 no.5
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• pp.868-876
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• 2020

The purpose of this study was to report the clinical effects of Korean medicine on a patient who suffered from Early Dumping Syndrome with diarrhea, abdominal pain, anorexia, and insomnia after gastrectomy. The patient was treated with herbal medicine, acupuncture and moxibustion use in combination with Western medicine for 4 weeks. Though anorexia was maintained at a similar level, other clinical symptoms (diarrhea, abdominal pain, and insomnia) were improved after Korean medicine treatment. Therefore, Korean medicine may be effective for treatment of Early Dumping Syndrome after gastrectomy.

• The Journal of Internal Korean Medicine
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• v.43 no.5
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• pp.1029-1036
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• 2022

The purpose of this study is to explore the effectiveness of Gamchobunmil-tang as a treatment for early dumping syndrome. A patient reported abdominal pain after eating, was not able to eat more than two spoons of thin rice gruel, and had lost 8 kg of his weight. The patient was treated with Gamchobunmil-tang three times a day for 12 days. The effects of the treatment were evaluated using the Visual Analogue Scale and the amount and form of the patient's intake. After treatment, the pain due to the dumping syndrome decreased. The Visual Analogue Scale score dropped significantly from 9 to 2, and increased amounts and novel forms of the food the patient consumed were observed. Despite the lack of a case, the results showed that Gamchobunmil-tang was effective in reducing the pain caused by the early dumping syndrome. Further research might prove that Gamchobunmil-tang could be an alternative treatment method for early dumping syndrome.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.1
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• pp.96-101
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• 2005

Dumping syndrome is a known complication of gastric surgery in adults, but a very rare disease in the pediatric population. We report on a case of dumping syndrome in a 19-month-old child, who underwent gastrojejunal feeding tube insertion for the treatment and prevention of gastroesophageal reflux and frequent aspiration pneumonia. At 17 months of age, 2 months after the beginning of gastrojejunal tube feeding, postprandial diaphoresis, palpitation, lethargy, bloating, and diarrhea occurred, and a single episode of convulsion with hypoglycemia were noted. Early and late dumping syndrome was confirmed by an abnormal oral glucose tolerance test with early onset hyperglycemia followed by delayed onset hypoglycemia. Diet therapy including uncooked corn starch then improved the postprandial diaphoresis, abnormal glucose levels, and her nutritional status. We conclude that dumping syndrome may be considered as a complication of gastrojejunal tube feeding in a child.

• The Journal of Internal Korean Medicine
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• v.38 no.5
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• pp.736-743
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• 2017

This clinical study describes the effect of Korean medicine as a treatment for early dumping syndrome. The patient was treated with herbal medicine (Sogeonjung-tang and Jeongjeon-gami-ijin-tang), acupuncture, and moxibustion for 34 days. The degree of treatment was measured by the amount of oral intake and the number of vomiting incidents. During the treatment, the patient's symptoms were relieved and the amount of oral intake increased. At first, the patient vomited once or twice per day, and the amount of oral intake was about 600-700 cc. After the treatment, the patient did not vomit and oral intake increased about two fold. This clinical case study shows the positive effect of herbal medicine, acupuncture, and moxibustion on relief of symptoms of early dumping syndrome.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.1
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• pp.92-98
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• 2001

The dumping syndrome has been a known complication of gastric surgery in adults, but it is recognized as a very rare disease in the pediatric population, especially in Korea. We report a case of dumping syndrome in a 10-month-old infant, who underwent Nissen fundoplication for the treatment of gastroesophageal reflux(GER). He was admitted because of aspiration pneumonia, and diagnosed as GER by 24-hour ambulatory esophageal pH monitoring test. For the treatment of GER, Nissen fundoplication was performed. After the operation, symptoms occurred within 30 minutes of meals, such as diaphoresis, palpitation, weakness, abdominal fullness, nausea, and diarrhea. The gastric emptying scan showed very rapid gastric emptying. His oral glucose tolerance tests revealed early-onset hyperglycema followed by delayed-onset hypoglycemia, which was the characteristic finding of the dumping syndrome. We introduced uncooked cornstarch to resolve symptoms and maintain the serum glucose level. After the feeding of uncooked cornstarch, his symptoms subsided and normal oral glucose test was restored. After the six months of treatment, his weight and height were increased dramatically from below 3 percentiles up to the normal range. The dumping syndrome should be considered when an infant suffers from the feeding difficulties after the gastric surgery like Nissen fundoplication, and the diet therapy including uncooked cornstarch could be applied as an effective measure.

• Journal of Gastric Cancer
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• v.20 no.2
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• pp.225-231
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• 2020

Gastric cancer is a rare condition affecting patients with familial adenomatous polyposis (FAP). The mainstay of treatment is total gastrectomy. Since duodenal cancer is the most common cause of death after total colectomy in FAP, endoscopic surveillance for duodenal cancer is mandatory. Here, we describe the use of an isoperistaltic jejunal loop interposition technique to reconstruct the digestive tract after total gastrectomy in 2 patients with FAP. There were no early or late complications. Both patients are still alive and in good clinical condition. They did not experience weight loss or symptoms of dumping syndrome. Duodenal endoscopic surveillance after this technique was easier than after the classical Roux-en-Y reconstruction. Hence, regular follow-up was possible for both patients.

• Journal of Gastric Cancer
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• v.16 no.2
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• pp.63-71
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• 2016

Pylorus-preserving gastrectomy (PPG) is a function-preserving surgery for the treatment of early gastric cancer (EGC), aiming to decrease the complication rate and improve postoperative quality of life. According to the Japanese gastric cancer treatment guidelines, PPG can be performed for cT1N0M0 gastric cancer located in the middle-third of the stomach, at least 4.0 cm away from the pylorus. Although the length of the antral cuff gradually increased, from 1.5 cm during the initial use of the procedure to 3.0 cm currently, its optimal length still remains unclear. Standard procedures for the preservation of pyloric function, infra-pyloric vessels, and hepatic branch of the vagus nerve, make PPG technically more difficult and raise concerns about incomplete lymph node dissection. The short- and long-term oncological and survival outcomes of PPG were comparable to those for distal gastrectomy, but with several advantages such as a lower incidence of dumping syndrome, bile reflux, and gallstone formation, and improved nutritional status. Gastric stasis, a typical complication of PPG, can be effectively treated by balloon dilatation and stent insertion. Robot-assisted pylorus-preserving gastrectomy is feasible for EGC in the middle-third of the stomach in terms of the short-term clinical outcome. However, any benefits over laparoscopy-assisted PPG (LAPPG) from the patient's perspective have not yet been proven. An ongoing Korean multicenter randomized controlled trial (KLASS-04), which compares LAPPG and laparoscopy-assisted distal gastrectomy for EGC in the middle-third of the stomach, may provide more clear evidence about the advantages and oncologic safety of PPG.