Comparison of effects of six main gastrectomy procedures on patients’ quality of life assessed by Postgastrectomy Syndrome Assessment Scale-45  

作　　者：Koji Nakada Yoshiyuki Kawashima Shinichi Kinami Ryoji Fukushima Hiroshi Yabusaki Akiyoshi Seshimo Naoki Hiki Keisuke Koeda Mikihiro Kano Yoshikazu Uenosono Atsushi Oshio Yasuhiro Kodera 

机构地区：[1]Department of Laboratory Medicine,The Jikei University School of Medicine,Tokyo 105-8461,Japan [2]Department of Gastroenterological Surgery,Saitama Cancer Center,Saitama 362-0806,Japan [3]Department of Surgical Oncology,Kanazawa Medical University,Kahoku-gun 920-0293,Ishikawa,Japan [4]Department of Surgery,Teikyo University School of Medicine,Tokyo 173-8605,Japan [5]Department of Surgery,Niigata Cancer Center Hospital,Niigata 951-8566,Japan [6]Department of Gastrointestinal and Pediatric Surgery,Tokyo Medical University,Tokyo 160-0023,Japan [7]Department of Upper Gastrointestinal Surgery,Kitasato University School of Medicine,Kanagawa 252-0374,Japan [8]Department of Medical Safety Science,Iwate Medical University,Iwate 028-3695,Japan [9]Department of Surgery,Hiroshima City Asa Citizens Hospital,Hiroshima 731-0293,Japan [10]Department of Digestive Surgery,Imamura General Hospital,Kagoshima 890-0064,Japan [11]Faculty of Letters,Arts and Sciences,Waseda University,Tokyo 162-8644,Japan [12]Department of Gastroenterological Surgery,Nagoya University Graduate School of Medicine,Nagoya 466-8550,Japan

出　　处：《World Journal of Gastrointestinal Surgery》2021年第5期461-475,共15页世界胃肠外科杂志（英文版）（电子版）

摘　　要：BACKGROUND The effects of various gastrectomy procedures on the patient’s quality of life(QOL)are not well understood.Thus,this nationwide multi-institutional crosssectional study using the Postgastrectomy Syndrome Assessment Scale-45(PGSAS-45),a well-established questionnaire designed to clarify the severity and characteristics of the postgastrectomy syndrome,was conducted.AIM To compare the effects of six main gastrectomy procedures on the postoperative QOL.METHODS Eligible questionnaires retrieved from 2368 patients who underwent either of six gastrectomy procedures[total gastrectomy with Roux-en-Y reconstruction(TGRY;n=393),proximal gastrectomy(PG;n=193),distal gastrectomy with Roux-en-Y reconstruction(DGRY;n=475),distal gastrectomy with Billroth-I reconstruction(DGBI;n=909),pylorus-preserving gastrectomy(PPG;n=313),and local resection of the stomach(LR;n=85)]were analyzed.Among the 19 main outcome measures of PGSAS-45,the severity and characteristics of postgastrectomy syndrome were compared for the aforementioned six gastrectomy procedures using analysis of means.RESULTS TGRY and PG significantly impaired the QOL of postoperative patients.Postoperative QOL was excellent in LR(cardia and pylorus were preserved with minimal resection).In procedures removing the distal stomach,diarrhea subscale(SS)and dumping SS were less frequent in PPG than in DGBI and DGRY.However,there was no difference in the postoperative QOL between DGBI and DGRY.The most noticeable adverse effects caused by gastrectomy were mealrelated distress SS,dissatisfaction at the meal,and weight loss,with significant differences among the surgical procedures.CONCLUSION Postoperative QOL greatly differed among six gastrectomy procedures.The severity and characteristics of postgastrectomy syndrome should be considered to select gastrectomy procedures,overcome surgical shortcomings,and enhance postoperative care.

关 键 词：GASTRECTOMY Quality of life Postgastrectomy syndromes Patient reported outcome measures 

分 类 号：R656.61[医药卫生—外科学]