Isozaki Hiroshi, Matsumoto Sasau, Murakami Shigeki, Takama Takehiro, Sho Tatsuo, Ishihara Kiyohiro, Sakai Kunihiko, Takeda Masanori, Nakada Koji, Fujiwara Toshiyoshi
Department of Surgery, Oomoto Hospital, Okayama 700-0924,
Acta Med Okayama. 2016;70(2):119-30. doi: 10.18926/AMO/54191.
Using the Postgastrectomy Syndrome Assessment Scale (PGSAS)-45, we compared the surgical outcomes and the quality of life (QOL) between patients undergoing limited gastrectomies and those undergoing conventional gastrectomies. In Oomoto Hospital between January 2004 and December 2013, a total of 124 patients who met the eligibility criteria were enrolled. Using the main outcome measures of PGSAS-45, we compared 4 types of limited gastrectomy procedures (1/2 distal gastrectomy [1/2DG] in 21 patients; pylorus-preserving gastrectomy [PPG] in 15 patients; segmental gastrectomy [SG] in 26 patients; and local resection [LR] in 13 patients) with conventional gastrectomy (total gastrectomy [TG] in 24 patients and 2/3 or more distal gastrectomy [WDG] in 25 patients). The TG group showed the worst QOL in almost all items of the main outcome measures. The 1/2DG, PPG, and SG groups showed better QOL than the WDG group in many of the main outcome measures, including the body weight ratio, total symptom score, ingested amount of food per meal, and the dissatisfaction for daily life subscale. The LR group showed a better intake of food than the 1/2DG, PPG, and SG groups. The body weight ratio of the LR group was better than that of the SG group. Diminished gastric resection preserved better QOL in patients with early gastric cancer.
我们使用胃切除术后综合征评估量表(PGSAS)-45,比较了接受有限胃切除术的患者与接受传统胃切除术的患者的手术结果及生活质量(QOL)。在2004年1月至2013年12月期间的大元医院,共有124名符合入选标准的患者入组。我们使用PGSAS-45的主要结局指标,比较了4种有限胃切除手术(21例患者接受1/2远端胃切除术[1/2DG];15例患者接受保留幽门胃切除术[PPG];26例患者接受节段性胃切除术[SG];13例患者接受局部切除术[LR])与传统胃切除术(24例患者接受全胃切除术[TG],25例患者接受2/3或以上远端胃切除术[WDG])。在主要结局指标的几乎所有项目中,TG组的生活质量最差。在包括体重比、总症状评分、每餐食物摄入量以及日常生活不满意子量表等许多主要结局指标方面,1/2DG组、PPG组和SG组的生活质量均优于WDG组。LR组的食物摄入量优于1/2DG组、PPG组和SG组。LR组的体重比优于SG组。对于早期胃癌患者,减少胃切除范围可更好地保留生活质量。