TY - JOUR
T1 - Comparison of Postoperative Quality of Life among Three Different Reconstruction Methods After Proximal Gastrectomy
T2 - Insights From the PGSAS Study
AU - Yabusaki, Hiroshi
AU - Kodera, Yasuhiro
AU - Fukushima, Norimasa
AU - Hiki, Naoki
AU - Kinami, Shinichi
AU - Yoshida, Masashi
AU - Aoyagi, Keishiro
AU - Ota, Shuichi
AU - Hata, Hiroaki
AU - Noro, Hiroshi
AU - Oshio, Atsushi
AU - Nakada, Koji
N1 - Funding Information:
Funding was provided by The Jikei University and the Japanese Society for Gastro-surgical Pathophysiology. Acknowledgments
Publisher Copyright:
© 2020, The Author(s).
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Background: Proximal gastrectomy (PG) has become an increasingly preferred procedure for early cancer in the upper third of the stomach, owing to reportedly superior quality of life (QOL) after PG when compared with total gastrectomy. However, various methods of reconstruction have currently been proposed. We compared the postoperative QOL among the three different reconstruction methods after PG using the Postgastrectomy Syndrome Assessment Scale-45 (PGSAS-45) questionnaire. Methods: Post Gastrectomy Syndrome Assessment Study (PGSAS), a nationwide multi-institutional survey, was conducted to evaluate QOL using the PGSAS-45 among various types of gastrectomy. Of the 2,368 eligible data from the PGSAS survey, data from 193 patients who underwent PG were retrieved and used in the current study. The PGSAS-45 consists of 45 items including 22 original gastrectomy specific items in addition to the SF-8 and GSRS. These were consolidated into 19 main outcome measures pertaining postgastrectomy symptoms, amount of food ingested, quality of ingestion, work, and level of satisfaction for daily work, and the three reconstruction methods (n = 193; 115 esophago-gastrostomy [PGEG], 34 jejunal interposition [PGJI], and 44 jejunal pouch interposition [PGJPI]) were compared using PGSAS-45. Results: Size of the remnant stomach was significantly larger in PGEG, and significantly smaller in PGJI and PGJPI (P < 0.05). There was no difference in other patient background factors among the groups. EGJPI tended to be superior to PGEG in several of the 19 main outcome with marginal significance (P = 0.047–0.076). Conclusion: PGJPI appears to be the most favorable of the three reconstruction methods after PG especially when the size of remnant stomach is rather small.
AB - Background: Proximal gastrectomy (PG) has become an increasingly preferred procedure for early cancer in the upper third of the stomach, owing to reportedly superior quality of life (QOL) after PG when compared with total gastrectomy. However, various methods of reconstruction have currently been proposed. We compared the postoperative QOL among the three different reconstruction methods after PG using the Postgastrectomy Syndrome Assessment Scale-45 (PGSAS-45) questionnaire. Methods: Post Gastrectomy Syndrome Assessment Study (PGSAS), a nationwide multi-institutional survey, was conducted to evaluate QOL using the PGSAS-45 among various types of gastrectomy. Of the 2,368 eligible data from the PGSAS survey, data from 193 patients who underwent PG were retrieved and used in the current study. The PGSAS-45 consists of 45 items including 22 original gastrectomy specific items in addition to the SF-8 and GSRS. These were consolidated into 19 main outcome measures pertaining postgastrectomy symptoms, amount of food ingested, quality of ingestion, work, and level of satisfaction for daily work, and the three reconstruction methods (n = 193; 115 esophago-gastrostomy [PGEG], 34 jejunal interposition [PGJI], and 44 jejunal pouch interposition [PGJPI]) were compared using PGSAS-45. Results: Size of the remnant stomach was significantly larger in PGEG, and significantly smaller in PGJI and PGJPI (P < 0.05). There was no difference in other patient background factors among the groups. EGJPI tended to be superior to PGEG in several of the 19 main outcome with marginal significance (P = 0.047–0.076). Conclusion: PGJPI appears to be the most favorable of the three reconstruction methods after PG especially when the size of remnant stomach is rather small.
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U2 - 10.1007/s00268-020-05629-5
DO - 10.1007/s00268-020-05629-5
M3 - Article
C2 - 32506229
AN - SCOPUS:85086039907
VL - 44
SP - 3433
EP - 3440
JO - World Journal of Surgery
JF - World Journal of Surgery
SN - 0364-2313
IS - 10
ER -