保留迷走神经的远端胃切除术与传统远端胃切除术对早期胃癌患者术后生活质量影响的随机对照试验

A Randomized Controlled Trial of Vagus Nerve-preserving Distal Gastrectomy Versus Conventional Distal Gastrectomy for Postoperative Quality of Life in Early Stage Gastric Cancer Patients.

作者信息

Kim Su Mi, Cho Juhee, Kang Danbee, Oh Seung Jong, Kim Ae Ran, Sohn Tae Sung, Noh Jae Hyoung, Kim Sung

机构信息

*Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea†Cancer Education Center, Samsung Medical Center, Sungkyunkwan University School of Medicine and Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea‡Departments of Epidemiology and Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD§Department of Surgery, National Police Hospital, Seoul, Korea¶Department of Nursing, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

Ann Surg. 2016 Jun;263(6):1079-84. doi: 10.1097/SLA.0000000000001565.

DOI:10.1097/SLA.0000000000001565

PMID:26727095

Abstract

OBJECTIVE

To compare the postoperative quality of life of vagus nerve preserving distal gastrectomy (VPG) vs conventional distal gastrectomy (CG) in patients with early-stage gastric cancer.

DESIGN

Randomized controlled clinical trial.

SETTING

Large tertiary comprehensive cancer center in Korea.

PARTICIPANTS

One hundred sixty-three patients with early gastric cancer 18 years of age or older expected to undergo curative gastric resection.

INTERVENTION

Patients were randomized 1:1 to VPG (n = 85) or CG (n = 78).

MAIN OUTCOME MEASURES

European Organization for Research and Treatment of Cancer (EORTC) gastric module (STO22).

RESULTS

Patients assigned to VPG showed less diarrhea 3 and 12 months after surgery (P = 0.040 and 0.048, respectively) and less appetite loss at 12 months (P = 0.011) compared with those assigned to CG. In both groups, fatigue, anxiety, eating restriction, and body image deteriorated at 3 months after surgery and did not regain baseline levels 12 months after surgery. There were no significant differences between the 2 groups in cancer recurrence and death over 5 years of follow-up.

CONCLUSIONS

Early gastric cancer patients undergoing VPG reported significantly less diarrhea and appetite loss at 12 months postsurgery compared with those undergoing CG, with no differences in long-term clinical outcomes. VPG may improve the quality of life after gastrectomy in early gastric cancer patients compared with CG.

摘要