腹腔镜辅助保留幽门胃切除术与腹腔镜辅助远端胃切除术后的生活质量比较：一项横断面邮寄问卷调查。

Postoperative quality of life after laparoscopy-assisted pylorus-preserving gastrectomy compared With laparoscopy-assisted distal gastrectomy: A cross-sectional postal questionnaire survey.

作者信息

Hosoda Kei, Yamashita Keishi, Sakuramoto Shinichi, Katada Natsuya, Moriya Hiromitsu, Mieno Hiroaki, Watanabe Masahiko

机构信息

Department of Surgery, Kitasato University School of Medicine, Kanagawa, Japan.

出版信息

Am J Surg. 2017 Apr;213(4):763-770. doi: 10.1016/j.amjsurg.2016.09.041. Epub 2016 Oct 8.

DOI:10.1016/j.amjsurg.2016.09.041

PMID:27751530

Abstract

BACKGROUND

Little is known about postgastrectomy syndrome and quality of life (QOL after laparoscopy-assisted pylorus-preserving gastrectomy (LAPPG). The aim of this study was to assess postgastrectomy syndrome and QOL after LAPPG as compared with laparoscopy-assisted distal gastrectomy with Billroth-I reconstruction (LADGBI).

METHODS

Postgastrectomy Syndrome Assessment Scale-45 (PGSAS-45) questionnaires were sent by mail to 167 patients. To balance the characteristics of the groups, propensity score matching was performed.

RESULTS

Of the 167 patients sent questionnaires, 112 (67%) responded, including 47 who underwent LAPPG and 65 who underwent LADGBI. After propensity score matching, the LAPPG group scored significantly better on the diarrhea and dumping subscales. Multiple regression analysis showed that female sex and LADGBI were independent factors predicting dumping. Evaluation of outcome measures for singular symptom showed that the LAPPG group scored significantly worse on the acid regurgitation subscale, but significantly better on the lower abdominal pain and early dumping abdominal subscales.

CONCLUSION

LAPPG is superior to LADGBI for ameliorating postgastrectomy syndrome and maintaining QOL. LAPPG is recommended for patients with cT1N0 middle third gastric cancer.

摘要

背景

关于腹腔镜辅助保留幽门胃切除术（LAPPG）后的胃切除术后综合征及生活质量（QOL）知之甚少。本研究旨在评估LAPPG术后的胃切除术后综合征及QOL，并与腹腔镜辅助毕Ⅰ式远端胃切除术（LADGBI）进行比较。

方法

通过邮件向167例患者发送胃切除术后综合征评估量表-45（PGSAS-45）问卷。为平衡各组特征，进行了倾向得分匹配。

结果

在167例发送问卷的患者中，112例（67%）回复，其中47例行LAPPG，65例行LADGBI。倾向得分匹配后，LAPPG组在腹泻和倾倒分量表上得分显著更高。多元回归分析显示，女性和LADGBI是预测倾倒的独立因素。对单一症状结局指标的评估显示，LAPPG组在反酸分量表上得分显著更低，但在下腹疼痛和早期倾倒腹部分量表上得分显著更高。