Effects of reconstruction methods on a patient’s quality of life after a proximal gastrectomy: subjective symptoms evaluation using questionnaire survey

• Published in: Langenbeck's archives of surgery 2009-07, Vol.394 (4), p.637-641
• Main Authors: Tokunaga, Masanori, Hiki, Naoki, Ohyama, Shigekazu, Nunobe, Souya, Miki, Akira, Fukunaga, Tetsu, Seto, Yasuyuki, Sano, Takeshi, Yamaguchi, Toshiharu
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Anastomosis, Surgical; Cardiac Surgery; Dumping Syndrome - epidemiology; Dumping Syndrome - prevention & control; Esophagus - surgery; Female; Gastrectomy - methods; Gastric Emptying; Gastrostomy; General Surgery; Humans; Jejunum - transplantation; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Postoperative Period; Quality of Life; Reconstructive Surgical Procedures - methods; Surveys and Questionnaires; Thoracic Surgery; Traumatic Surgery; Vascular Surgery
• ISSN: 1435-2443; 1435-2451
• DOI: 10.1007/s00423-008-0442-z

Background and aims Proximal gastrectomy is typically indicated in early gastric cancer of the upper third of the stomach. Esophagogastrostomy (EG) and jejunum interposition (JI) are often selected as reconstruction methods, although the more appropriate method of the two is unknown. Materials and methods One hundred and seven patients, who underwent a proximal gastrectomy followed by either an EG or a JI, were sent a questionnaire of 33 questions about subjective symptoms. Eighty-three patients (45 in the JI group and 38 in the EG group) returned the questionnaire. Results were compared between the two groups to identify the appropriate reconstruction method after a proximal gastrectomy. Also, changes in a patient’s body weight after surgery were compared. Results Early and late dumping syndromes and gastroesophageal reflux associated symptoms were equally observed between the two groups. However, abdominal discomfort after meals ( P  = 0.008), continuous gastric fullness ( P  = 0.028), and hiccups between meals ( P  = 0.022) were often observed in the JI group. The loss of body weight was not significantly different between the two groups. Conclusion EG is a better reconstruction method compared to a JI after a proximal gastrectomy when evaluating subjective symptoms. Prospective study is warranted to clarify the better reconstruction method following proximal gastrectomy in terms of both subjective and objective symptoms.