Quality of life after total vs distal gastrectomy with Roux-en-Y reconstruction: Use of the Postgastrectomy Syndrome Assessment Scale-45

Abstract

AIMTo investigate the detrimental impact of loss of reservoir capacity by comparing total gastrectomy (TGRY) and distal gastrectomy with the same Roux-en-Y (DGRY) reconstruction. The study was conducted using an integrated questionnaire, the Postgastrectomy Syndrome Assessment Scale (PGSAS)-45, recently developed by the Japan Postgastrectomy Syndrome Working Party.METHODSThe PGSAS-45 comprises 8 items from the Short Form-8, 15 from the Gastrointestinal Symptom Rating Scale, and 22 newly selected items. Uni- and multivariate analysis was performed on 868 questionnaires completed by patients who underwent either TGRY (n = 393) or DGRY (n = 475) for stage I gastric cancer (52 institutions). Multivariate analysis weighed of six explanatory variables, including the type of gastrectomy (TGRY/DGRY), interval after surgery, age, gender, surgical approach (laparoscopic/open), and whether the celiac branch of the vagus nerve was preserved/divided on the quality of life (QOL).RESULTSThe patients who underwent TGRY experienced the poorer QOL compared to DGRY in the 15 of 19 main outcome measures of PGSAS-45. Moreover, multiple regression analysis indicated that the type of gastrectomy, TGRY, most strongly and broadly impaired the postoperative QOL among six explanatory variables.CONCLUSIONThe results of the present study suggested that TGRY had a certain detrimental impact on the postoperative QOL, and the loss of reservoir capacity could be a major cause.

C‐reactive protein/albumin ratio is a poor prognostic factor of esophagogastric junction and upper gastric cancer

“…Recent studies have reported that distal gastrectomy results in a better long‐term survival for patients with distal gastric cancer compared with total gastrectomy . Also, patients who undergo total gastrectomy have a reduced postoperative quality of life when compared with patients who undergo distal gastrectomy . Adenocarcinoma of the esophagogastric junction (AEG) is a type of malignant tumor located between the esophagus and stomach and was initially characterized in 1999 by Siewert .…”

“…1,2 Also, patients who undergo total gastrectomy have a reduced postoperative quality of life when compared with patients who undergo distal gastrectomy. 3 Adenocarcinoma of the esophagogastric junction (AEG) is a type of malignant tumor located between the esophagus and stomach and was initially characterized in 1999 by Siewert. 4 AEG was known to have unique clinicopathological characteristics and biological behavior.…”

Long-term quality of life and nutrition status of the aboral pouch reconstruction after total gastrectomy for gastric cancer: a prospective multicenter observational study (CCOG1505)

“…We hypothesized, however, that the reconstruction procedure could still influence the QOL and nutritional outcomes in the long term [12]. Moreover, Postgastrectomy Syndrome Assessment Scale (PGSAS) [13], new integrated questionnaires to more specifically address the issue of QOL after gastrectomy, have recently emerged and shown promise in several observational studies [14][15][16].…”

The surgical procedure for esophagogastric junction cancer — discussing the tactics

“…[21] и М. Takahashi и соавт. [22] подтверждают более тяжелый и длительный период восстановления физической и социальной активности после тотальной радикальной операции, по большей части в плане расстройства питания вследствие полного отсутствия желудка и лимитирования количества поступающей пищи. По данным М. Takahashi и соавт.…”

“…По данным М. Takahashi и соавт. [22], потеря в весе после операций на протяжении первого года составила 13,8% в группе тотальной гастрэктомии, 8,9% -в группе пар-ОБЗОРЫ https://doi.org/10.17816/clinpractXXXX циальной резекции желудка. Авторы указывают на положительное влияние сохранения желудочно-пищеводного сфинктера и кардии желудка для снижения риска развития рефлюкс-синдрома.…”