Defecation disorders are crucial sequelae that impairs the quality of life of patients after conventional gastrectomy  

作　　者：Koji Nakada Masami Ikeda Masazumi Takahashi Shinichi Kinami Masashi Yoshida Yoshikazu Uenosono Masanori Terashima Atsushi Oshio Yasuhiro Kodera 

机构地区：[1]University School of Medicine,Tokyo 105-8461,Japan [2]Department of Surgery,Asama General Hospital,Saku 385-0022,Japan [3]Division of Gastroenterological Surgery,Yokohama Municipal Citizen’s Hospital,Yokohama 240-8555,Japan [4]Department of Surgical Oncology,Kanazawa Medical School,Kanazawa 920-0293,Japan [5]Department of Surgery,International University of Health and Welfare Hospital,Tochigi 329-2763,Japan [6]Department of Digestive Surgery,Imamura General Hospital,Kagoshima 890-0064,Japan [7]Division of Gastric Surgery,Shizuoka Cancer Center,Shizuoka 411-8777,Japan [8]Faculty of Letters,Arts and Sciences,Waseda University,Tokyo 169-8050,Japan [9]Department of Gastroenterological Surgery,Nagoya University Graduate School of Medicine,Nagoya 466-8550,Japan

出　　处：《World Journal of Gastrointestinal Surgery》2021年第11期1484-1496,共13页世界胃肠外科杂志（英文版）（电子版）

基　　金：Supported by Jikei University;Japanese Society for Gastrosurgical Pathophysiology。

摘　　要：BACKGROUND Defecation disorders are obscure sequelae that occurs after gastrectomy,and its implication on daily lives of patients have not been sufficiently investigated.AIM To examine the features of defecation disorders after gastrectomy and to explore its implication on daily lives of patients in a large cohort using the Postgast rectomy Syndrome Assessment Scale(PGSAS)-45.METHODS We conducted a nationwide multi-institutional study using PGSAS-45 to examine the prevalence of postgastrectomy syndrome and its impact on daily lives of patients after various types of gastrectomy.Data were obtained from 2368 eligible patients at 52 institutions in Japan.Of these,1777 patients who underwent total gastrectomy(TG;n=393)or distal gastrectomy(DG;n=1384)were examined.The severity of defecation disorder symptoms,such as diarrhea and constipation,and their correlation with other postgastrectomy symptoms were examined.The importance of defecation disorder symptoms on the living states and quality of life(QOL)of postgastrectomy patients,and those clinical factors that affect the severity of defecation disorder symptoms were evaluated using multiple regression analysis.RESULTS Among seven symptom subscales of PGSAS-45,the ranking of diarrhea was 4th in TG and 2nd in DG.The ranking of constipation was 5th in TG and 1st in DG.The symptoms that correlated well with diarrhea were dumping and indigestion in both TG and DG;while those with constipation were abdominal pain and mealrelated distress in TG,and were meal-related distress and indigestion in DG.Among five main outcome measures(MOMs)of living status domain,constipation significantly impaired four MOMs,while diarrhea had no effect in TG.Both diarrhea and constipation impaired most of five MOMs in DG.Among six MOMs of QOL domain,diarrhea impaired one MOM,whereas constipation impaired all six MOMs in TG.Both diarrhea and constipation equally impaired all MOMs in DG.Male sex,younger age,division of the celiac branch of vagus nerve,and TG,independently worsened diarrhea,while f

关 键 词：Postgastrectomy syndrome Defecation disorders Quality of life Patientreported outcome measures GASTRECTOMY 

分 类 号：R656.61[医药卫生—外科学]