Reliability and Validity of a New Scale to Assess Postoperative Dysfunction After Resection of Upper Gastrointestinal Carcinoma

Nakamura, Misuzu; Kido, Yoshihiro; Yano, Masahiko; Hosoya, Yoshinori

doi:10.1007/s00595-005-2988-5

Cited by 32 publications

(23 citation statements)

References 16 publications

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“…The DAUGS 20 scale was designed to objectively assess gastrointestinal dysfunction after surgery for upper gastrointestinal cancer. The scale has already been validated in the field of upper intestinal cancer [17,18]. We found no significant difference between R-Y and B-I procedures in terms of overall postoperative dysfunction.…”

Section: Discussionmentioning

confidence: 53%

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A comparison of postoperative quality of life and dysfunction after Billroth I and Roux-en-Y reconstruction following distal gastrectomy for gastric cancer: results from a multi-institutional RCT

et al. 2011

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Background Both Billroth I (B-I) and Roux-en-Y (R-Y) reconstructions are commonly performed as standard procedures, but it has yet to be determined which reconstruction is better for patients. A randomized prospective phase II trial with body weight loss at 1 year after surgery as a primary endpoint was performed to address this issue. The current report delivers data on the quality of life and degree of postoperative dysfunction, which were the secondary endpoints of this study.Methods Gastric cancer patients who underwent distal gastrectomy were intraoperatively randomized to B-I or R-Y. Postsurgical QOL was evaluated using the EORTC QLQ-C30 and DAUGS 20. Results Between August 2005 and December 2008, 332 patients were enrolled in a randomized trial comparing B-I versus R-Y. A mail survey questionnaire sent to 327 patients was completed by 268 (86.2%) of them. EORTC QLQ-C30 scores were as follows: global health status was similar in each group (B-I 73.5 ± 18.8, R-Y 73.2 ± 20.2, p = 0.87). Scores of five functional scales were also similar. Only the dyspnea symptom scale showed superior results for R-Y than for B-I (B-I 13.6 ± 17.9, R-Y 8.6 ± 16.3, p = 0.02). With respect to DAUGS 20, the total score did not differ significantly between the R-Y and B-I groups (24.8 vs. 23.6, p = 0.41). Only reflux symptoms were significantly worse for B-I than for R-Y (0.7 ± 0.6 vs. 0.5 ± 0.6, p = 0.01). Conclusions The B-I and R-Y techniques were generally equivalent in terms of postoperative QOL and dysfunction. Both procedures seem acceptable as standard reconstructions after distal gastrectomy with regard to postoperative QOL and dysfunction.

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Section: Discussionmentioning

confidence: 53%

“…The DAUGS 20 has previously undergone extensive development and testing [17,18], and was originally developed for simultaneous use with the EORTC QLQ-C30. The patients rated 20 items related to postoperative gastrointestinal dysfunction according to a scale of 1 (not at all) to 5 (very severe).…”

Section: Assessment Of Postoperative Dysfunctionmentioning

confidence: 99%

A comparison of postoperative quality of life and dysfunction after Billroth I and Roux-en-Y reconstruction following distal gastrectomy for gastric cancer: results from a multi-institutional RCT

et al. 2011

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“…This goal is particularly important in the Far East where gastric cancer is often found at early clinical stages so that more patients manage to survive their cancer and consequently need to face the PGS in the long term [9]. It is known that the type of gastrectomy affects the incidence and severity of PGS [10][11][12][13][14][15][16][17][18][19][20][21], and various procedures to preserve or reconstruct gastric function have been proposed to confront these problems [7,8]. To gain deeper understanding of the PGS, a group of iatrogenic disorders, and treat them appropriately, it is important to grasp the impact of various symptoms, along with feeding problems and body weight loss, to the living status and QOL of the patients.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, there are possibilities that a large proportion of these studies have overlooked several important postgastrectomy symptoms that actually affect the living status of the patients but cannot be evaluated by conventional scales. More recently, Nakamura et al reported on DAUGS, a questionnaire designed to measure symptoms after upper gastrointestinal surgery, and the actual attempt to use this in the clinical setting [16,21]. However, items concerning living status or QOL of the patients rather than the symptoms were lacking in the DAUGS.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and clinical relevance of postgastrectomy syndrome assessment scale (PGSAS)-45: newly developed integrated questionnaires for assessment of living status and quality of life in postgastrectomy patients

et al. 2014

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Background Lack of a suitable instrument to comprehensively assess symptoms, living status, and quality of life in postgastrectomy patients prompted the authors to develop postgastrectomy syndrome assessment scale (PGSAS)-45. Methods PGSAS-45 consists of 45 items in total: 8 items from SF-8, 15 items from GSRS, and an additional 22 items selected by 47 gastric surgeons. Using the PGSAS-45, a multi-institutional survey was conducted to determine the prevalence of postgastrectomy syndrome and its impact on everyday life among patients who underwent various types of gastrectomy. Eligible data were obtained from 2,368 patients operated and followed at 52 institutions in Japan. Of these, data from 1,777 patients were used in the current study in which symptom subscales of the PGSAS-45 were determined. We also considered the characteristics of the postgastrectomy syndrome and to what extent these symptoms influence patients' living status and quality of life (QOL).Results By factor analysis, 23 symptom-related items of PGSAS-45 were successfully clustered into seven symptom subscales that represent esophageal reflux, abdominal pain, meal-related distress, indigestion, diarrhea, constipation, and dumping. These seven symptom subscales and two other subscales measuring quality of ingestion and dissatisfaction for daily life, respectively, had good internal consistency in terms of Cronbach 0 s a (0.65-0.88).

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“…In the past 10 years, tools developed include the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire STO22 (EORTC QOL-SO22) (stomach cancer-specific instrument for clinical trials published in 2001) and the Functional Assessment of Cancer Therapy-Gastric Quality of Life Instrument (FACgc) (validated in 2010) [23,24]. The Dysfunction after Upper Gastrointestinal Surgery for Cancer (DAUG S32), developed to assess QOL after cancer-related surgery, has also been validated and applies to the gastric cancer population [25]. A few of the studies included in this review were conducted prior to the development of validated tools in this field.…”

Section: Measurement Toolsmentioning

confidence: 99%

Effective palliation and quality of life outcomes in studies of surgery for advanced, non-curative gastric cancer: a systematic review

et al. 2011

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Background Relief of symptoms should be the primary focus of palliative treatment as defined by the World Health Organization. Evaluating the effectiveness of palliative interventions should incorporate this goal and include quality of life (QOL) outcome assessments. A systematic review of the surgical gastric cancer literature was performed to summarize the effectiveness of palliative surgical interventions in addressing QOL. Methods An electronic literature search of EMBASE, Medline, and the Cochrane Database of Controlled Trials was performed from January 1, 1985 to December 1, 2009. English language abstracts and articles were reviewed independently by two reviewers. A systematic approach to data abstraction and presentation was followed.Results No articles were identified as reporting true QOL outcomes using reliable, validated QOL instruments in surgically managed, advanced gastric cancer patients. Nine articles were identified as reporting outcomes measuring effectiveness of palliation. Commonly reported pre-procedure symptoms were weight loss, abdominal pain, vomiting, obstruction, and bleeding. Time to oral intake was reported in 5 of 9 studies, ranging from a mean of 2.9 days (laparoscopic gastrojejunostomy) to 8 days (surgical bypass). Length of postoperative inpatient stay ranged from a mean of 7 days (gastrojejunostomy) to 28 days (surgical bypass). Other measures of effective palliation included measures of clinical success, hospital readmission rates, and post-procedure analgesic intake. Conclusion A paucity of literature exists regarding the QOL of surgically managed gastric cancer patients. Prospectively designed studies using credible QOL measures are necessary to better inform the treatment decisionmaking process for these patients.

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Reliability and Validity of a New Scale to Assess Postoperative Dysfunction After Resection of Upper Gastrointestinal Carcinoma

Abstract: Our preliminary scale is sufficiently reliable and valid, and will prove to be clinically useful.

Cited by 32 publications

References 16 publications

A comparison of postoperative quality of life and dysfunction after Billroth I and Roux-en-Y reconstruction following distal gastrectomy for gastric cancer: results from a multi-institutional RCT

A comparison of postoperative quality of life and dysfunction after Billroth I and Roux-en-Y reconstruction following distal gastrectomy for gastric cancer: results from a multi-institutional RCT

Characteristics and clinical relevance of postgastrectomy syndrome assessment scale (PGSAS)-45: newly developed integrated questionnaires for assessment of living status and quality of life in postgastrectomy patients

Effective palliation and quality of life outcomes in studies of surgery for advanced, non-curative gastric cancer: a systematic review

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