Quality of life beyond the early postoperative period after laparoscopy-assisted distal gastrectomy: the level of patient expectation as the essence of quality of life

Lee, Seung Soo; Ryu, Seung Wan; Kim, In Ho; Sohn, Soo Sang

doi:10.1007/s10120-011-0113-6

Cited by 24 publications

(17 citation statements)

References 21 publications

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“…However, it remains unclear whether laparoscopic gastrectomy alleviates PGS. There are reports of improved postoperative QoL following laparoscopic gastrectomy[14] and also reports wherein the QoL deteriorated[15]. This difference seems to depend on the timing of the assessment.…”

Section: Discussionmentioning

confidence: 99%

Background factors influencing postgastrectomy syndromes after various types of gastrectomy

Kinami

Takahashi

Urushihara

et al. 2018

WJCC

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BACKGROUNDPostgastrectomy syndromes (PGS) after curative gastrectomy for gastric cancer are influenced by not only gastrectomy type but also by background factors. Recently, a nationwide PGS study was performed using the Postgastrectomy Syndrome Assessment Scale-45 (PGSAS-45) questionnaire.AIMTo determine the influence of each background factor on PGS for each gastrectomy type using PGS assessment study (PGSAS) data as an additional analysis.METHODSThe data of 2368 patients were obtained from the PGSAS. This included patients undergoing distal gastrectomy (DG) with Billroth I reconstruction, DG with Roux-en-Y reconstruction, total gastrectomy with Roux-en-Y, proximal gastrectomy, pylorus-preserving gastrectomy (PPG), and local resection. Multiple regression analysis was performed to explore the independent effects of each background factor on the main outcome measures (MOMs) of PGSAS-45 for each gastrectomy type. The background factors included postoperative period, age, sex, surgical approach (laparoscopic or open), and the status of the celiac branch of the vagal nerve.RESULTSThe MOMs of DG and PPG were highly affected by background factors, whereas those of total gastrectomy with Roux-en-Y, proximal gastrectomy, and local resection were not. Worse PGS were found in females, whereas a longer postoperative period alleviated some of the MOMs. For DG and PPG, a laparoscopic approach and preservation of the celiac branch improved several MOMs.CONCLUSIONVarious background factors affected PGS, and their influence varied with the type of gastrectomy performed. Laparoscopic surgery and celiac branch preservation can improve PGS in patients undergoing DG and PPG.

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Section: Discussionmentioning

confidence: 99%

Background factors influencing postgastrectomy syndromes after various types of gastrectomy

Kinami

Takahashi

Urushihara

et al. 2018

WJCC

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“…However, such techniques never gain much popularity, and most patients with gastric cancer at the upper part of the stomach undergo TG, in which a restricted food reservoir is inevitable. As QoL is the gap between reality and expectation,25,26 providing patients with definitive informing regarding the restrictive symptoms they need to follow after surgery for a considerable amount of time, rather than providing obscure information about symptom resolution in the indefinite future, may reduce the gap in QoL. Furthermore, QoL is the patient perception of their position in life,27 and any efforts to alter their perception would be helpful for improving QoL.…”

Section: Discussionmentioning

confidence: 99%

Serial Comparisons of Quality of Life after Distal Subtotal or Total Gastrectomy: What Are the Rational Approaches for Quality of Life Management?

et al. 2014

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PurposeThe aims of this study were to make serial comparisons of the quality of life (QoL) between patients who underwent total gastrectomy and those who underwent distal subtotal gastrectomy for gastric cancer and to identify the affected scales with consistency.Materials and MethodsQoL data of 275 patients who were admitted for surgery between September 2008 and June 2011 and who underwent subtotal gastrectomy or total gastrectomy were obtained preoperatively and postoperatively at 3, 6, 9, 12, 18, and 24 months. The Korean versions of the European Organization for Research and Treatment (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) and the gastric cancer specific module, the EORTC QLQ-STO22, were used to assess QoL.ResultsQoL, as assessed by the global health status/QoL and physical functioning, revealed a brief divergence with worse QoL in the total gastrectomy group 3 months postoperatively, followed by rapid convergence. QoL related to restrictive symptoms (nausea/vomiting, dysphagia, reflux, and eating restrictions) and dry mouth was consistently worse in the total gastrectomy group during the first 2 postoperative years.ConclusionsThe general QoL of patients after gastrectomy is highly congruent with subjective physical functioning, and the differences between patients who undergo total gastrectomy and subtotal gastrectomy are no longer valid several months after surgery. In order to further reduce the differences in QoL between patients who underwent total gastrectomy and subtotal gastrectomy, definitive preoperative informing, followed by postoperative symptomatic management, of restrictive symptoms in total gastrectomy patients is the most rational approach.

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“…Liu et al [20] used EORTC QLQ-C30 and STO22 and reported superior HRQOL of the LAG at a mean follow-up time of 21 months. Lee et al [21] also used EORTC QLQ-C30 and STO22 and reported inferior HRQOL of the LAG at a mean follow-up time of 22 months. In all these studies, the time point for evaluation of the HRQOL had not been prespecified, and moreover the data at baseline (before surgery) were unavailable.…”

Section: Discussionmentioning

confidence: 99%

Long-term quality of life after laparoscopic distal gastrectomy for early gastric cancer: results of a prospective multi-institutional comparative trial

et al. 2014

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Background The aim of this study was to compare the postoperative health-related quality of life (HRQOL) between open and laparoscopic distal gastrectomy. Methods A multi-institutional nonrandomized study was conducted. Patients with clinical T1 gastric cancer were prospectively enrolled and underwent distal gastrectomy by either the open or laparoscopic approach. HRQOL was measured using the European Organization for Research and Treatment of Cancer, Quality of Life QuestionnaireCore 30 and the site-specific module for gastric cancer. Questionnaires were completed at baseline and at 1, 3, 6, and 12 months postoperatively. Clinicopathological characteristics and short-term outcome including postoperative morbidity and HRQOL were compared between the approaches.Results A total of 145 patients (open, n = 72; laparoscopic, n = 73) were enrolled between September 2008 and January 2011 and analyzed. The laparoscopic approach was associated with longer operating time, less blood loss, and a similar incidence of postoperative complications. At each time point, the questionnaires were retrieved from more than 90 % of the patients. The worst scores for most of the scales were observed at 1 month postoperatively and improved thereafter. No statistically significant differences were observed regarding physical functioning, the primary endpoint. On the other hand, role, emotional, cognitive, and social functioning scores were superior in the laparoscopic group at 6 and 12 months postoperatively. Symptom scales including fatigue, pain, eating restriction, taste problems, and anxiety were better in the laparoscopic group before 6 months but not at 12 months.

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Quality of life beyond the early postoperative period after laparoscopy-assisted distal gastrectomy: the level of patient expectation as the essence of quality of life

Cited by 24 publications

References 21 publications

Background factors influencing postgastrectomy syndromes after various types of gastrectomy

Background factors influencing postgastrectomy syndromes after various types of gastrectomy

Serial Comparisons of Quality of Life after Distal Subtotal or Total Gastrectomy: What Are the Rational Approaches for Quality of Life Management?

Long-term quality of life after laparoscopic distal gastrectomy for early gastric cancer: results of a prospective multi-institutional comparative trial

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