Yu.A. Igonin1, Yu.D. Ilivanov1, S.Yu. Ilivanov2, O.Yu. Dolgov1, R.Sh. Khasanov2
1Chuvash State University named after I.N. Ulyanov, Cheboksary
2Kazan State Medical Academy — Branch of the FSBEI FPE RMACPE MOH Russia, Kazan
Igonin Yu.A. — Cand. Med. Sc., Associate Professor of the Department of General Surgery and Oncology of Chuvash State University named after I.N. Ulyanov
15 Moskovskiy Ave., Cheboksary, Russian Federation, 428015
Abstract. The purpose of this research is to identify and assess diagnostic methods for dumping syndrome, its different degrees of severity in patients with gastric cancer after gastrectomy. Two methods of specific diagnostics are proposed: рrolonged esophago-jejunoscopic method, which was used on 24 patients, and modified radiology method with contrast (with the passage of barium through the esophago-jejunum complex), which was used on 27 patients. These methods enabled us to identify the clinical course of dumping syndrome which can be divided as follows: hyperperistaltic ― characteristic for the mild form of dumping syndrome, and hypoperistaltic (atonic) ― characteristic for moderate and severe forms. The prolonged esophago-jejunoscopic method established that the severity of clinical manifestation of dumping syndrome depends on the number of times there is reflux of intestinal content into the esophagus. In mild cases the number of times is 7.6±0.49 (P<0.001), in moderate cases is 13.5±0.69 (P<0.001), and in severe cases is 13.4±0.8 (P<0.001). The modified radiology method with contrast established that in mild cases of dumping syndrome contrast is evacuated through the esophago-jejunum complex after 15 minutes. In moderate and severe cases after 150-180 minutes. It was also established that in cases where reflux incidences were lowered, i.e., for mild cases lowered to 2.4±0.24 (P<0.001), moderate cases to 3.1±0.24 (P<0.001), and severe cases to 3.4±0.67 (P<0.001, and exposure time for contrast in the esophago-jejunum complex is limited to 60-90 minutes, the clinical manifestation of dumping syndrome either disappears, or the severity and intensity dramatically reduces.
Key words: gastrectomy, complications following gastric surgery, dumping syndrome, diagnostic methods.