Quality of life after totally laparoscopic proximal gastrectomy with double-tract reconstruction versus totally laparoscopic total gastrectomy: Retrospective cohort study

Abstract

Background Gastrectomy remains a major surgery that may result in significant deterioration of the patient's health-related quality of life (QOL). This study assessed differences in short- and long-term QOL among patients following Totally Laparoscopic Proximal Gastrectomy with Double-Tract reconstruction (TLPG-DT) in comparison to those of Totally Laparoscopic Total Gastrectomy (TLTG). Methods Patients with gastric cancer who underwent totally laparoscopic proximal and total gastrectomy in the Department of General Surgery, Huashan Hospital, Fudan University, from January 2015 to January 2020 were collected and retrospectively analyzed. Participants completed the EORTC cancer (QLQ-C30) and gastric (QLQ-STO22) questionnaires less than six months after surgery and more than one year after surgery. Results There were 25 patients who underwent TLPG-DT and 30 patients who underwent TLTG. For short-term outcomes, TLPG-DT patients had worse social function (p-value = 0.014), appetite (p-value = 0.038), and anxiety (p-value = 0.004) than TLTG patients. As for long-term outcomes, patients in both groups had similar quality-of-life scores. Patients in the TLPG-DT group had higher albumin and hemoglobin levels, as well as more time and cost for the procedure (paid ¥8,713 and ¥1,271 more than patients in the TLTG group in terms of total cost and consumables cost, respectively). There was no difference in complications and OS between the two groups. Conclusions The short-term QOL of TLPG-DT patients was inferior to that of TLTG patients, while there was no significant difference in the long-term QOL between them. TLPG-DT had a satisfactory QOL, which, combined with the better nutritional status of this group of patients after surgery, warrants replication in established surgical centers.

Double-tract vs gastric tube reconstruction after proximal gastrectomy in upper third gastric cancer: a Propensity Score Matching Analysis

“…Therefore, EG is usually accompanied by anti-re ux procedures, including gastric tube reconstruction, double-ap, side overlap, fundoplication, and rebuild of fundus and HIS Angle. Gastric tube reconstruction reduces the amount of acid-secreting gastric tissue, and an arti cial fundus structure above the anastomosis can cushion acid re ux [25] . A comparative study by Chen showed a re ux rate of 11.8% (n = 34) with gastric tube reconstruction [26] .…”

Safety and efficacy of overlapping triangular anastomoses in complete laparoscopic colorectal resection: a systematic evaluation and Meta-analysis

“…To better answer this question, we need to analyze the clinical outcomes of overlapping triangulation and other anastomosis procedures in terms of surgical e cacy. Because the operation is performed in pneumoperitoneum [30] ,there is no need to add another opening in the abdominal wall, reducing the pain of the patient [31] .However, the location of intracavitary bleeding can be easily determined by using the linear stapler of esophagojejunum under endoscope.…”