Roder J D, Herschbach P, Henrich G, Nagel M, Böttcher K, Siewert J R
Chirurgische Klinik und Poliklinik, Technische Universität München.
Dtsch Med Wochenschr. 1992 Feb 14;117(7):241-7. doi: 10.1055/s-2008-1062303.
A group of 178 patients with total gastrectomy for gastric carcinoma were divided into two groups matched for sex, age, tumour stage and follow-up interval (29 pairs, 46 men and 12 women; mean age 63.4 [39-74] years) according to the type of reconstruction performed, oesophagojejunal plication with pouch or simple oesophagojejunostomy without pouch. Those with left-extended gastrectomy, follow-up period of 9 months or less, and local recurrence or metastasis were excluded. Quality of life was evaluated by means of three standardized questionnaires sent to all the patients: (1) general physical complaints; (2) satisfaction with life; and (3) psychosocial burden. Patients with pouch reconstruction declared more favourable results in 90 of the 94 questions contained in the questionnaire (96%) than the patients without pouch. Patients in the former group also had significantly fewer general physical complaints (P less than or equal to 0.05) and were significantly more satisfied with life (P less than or equal to 0.05) than those without pouch. Correlation analysis for the entire group (n = 58) indicated significant relationships especially between quality of life and postoperative nutrition and body weight. Technical surgical problems of total gastrectomy having largely been solved, the question of quality of life must increasingly determine the choice of treatment.
一组178例行胃癌全胃切除术的患者，根据重建方式分为两组，即带贮袋的食管空肠襞叠术或不带贮袋的单纯食管空肠吻合术，两组在性别、年龄、肿瘤分期和随访间隔方面相匹配（共29对，46例男性和12例女性；平均年龄63.4[39 - 74]岁）。排除行左半扩大根治性胃切除术、随访时间9个月或更短、以及局部复发或转移的患者。通过向所有患者发放三份标准化问卷来评估生活质量：（1）一般身体不适；（2）生活满意度；（3）心理社会负担。在问卷包含的94个问题中，行贮袋重建的患者在90个问题（96%）中给出了更有利的结果，比未行贮袋重建的患者更多。前一组患者的一般身体不适也显著更少（P≤0.05），并且比未行贮袋重建的患者对生活的满意度显著更高（P≤0.05）。对整个组（n = 58）的相关分析表明，尤其是生活质量与术后营养和体重之间存在显著关系。全胃切除术的技术手术问题在很大程度上已得到解决，生活质量问题必须越来越多地决定治疗方案的选择。
