Comparison of Postoperative Quality of Life among Three Different Reconstruction Methods After Proximal Gastrectomy: Ins
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ORIGINAL SCIENTIFIC REPORT
Comparison of Postoperative Quality of Life among Three Different Reconstruction Methods After Proximal Gastrectomy: Insights From the PGSAS Study Hiroshi Yabusaki1 • Yasuhiro Kodera2 • Norimasa Fukushima3 • Naoki Hiki4 • Shinichi Kinami5 • Masashi Yoshida6 • Keishiro Aoyagi7 • Shuichi Ota8 • Hiroaki Hata9 • Hiroshi Noro10 • Atsushi Oshio11 • Koji Nakada12
Ó The Author(s) 2020
Abstract 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. Trial registration number UMIN-CTR #000002116 entitled as ‘‘A study to observe correlation between resection and reconstruction procedures employed for gastric neoplasms and development of postgastrectomy syndrome’’
& Hiroshi Yabusaki [email protected]
Masashi Yoshida [email protected]
Yasuhiro Kodera [email protected]
Keishiro Aoyagi [email protected]
Norimasa Fukushima [email protected]
Shuichi Ota [email protected]
Naoki Hiki [email protected]
Hiroaki Hata [email protected]
Shinichi Kinami [email protected]
Hiroshi Noro [email protected]
123
World J Surg
Introduction Although the relative frequency of early gastric cancer existing on one-thirds of upper part of the stomach has been increasing [1, 2], no standard surgical procedure has been proposed based on robust clinical data [3, 4]. Recently, Po
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