Department of Gastrointestinal Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
J Gastroenterol Hepatol. 2020 Oct;35(10):1712-1719. doi: 10.1111/jgh.14985. Epub 2020 Feb 11.
This study aimed to investigate the postoperative quality of life (QOL) between laparoscopy-assisted pylorus-preserving gastrectomy (LAPPG) and laparoscopy-assisted distal gastrectomy with Billroth I anastomosis (LADGBI) in patients with middle-third early gastric cancers (EGC).
From January 2015 to August 2017, a total 91 patients with EGC underwent LAPPG or LADGBI procedure with complete QLQ-C30 and QLQ-STO22 in Ren Ji Hospital. Not only do surgical and oncological safety as well as clinicopathologic characteristics analyze, but also chronological changes of QOL and nutritional status were compared for the evaluation of functional advantages.
There was no significant difference in clinicopathologic characteristics and perioperative recovery between LAPPG and LADGBI. During postoperative 2-year follow up, LAPPG showed significant advantages over LADGBI in emotional functioning, insomnia, appetite loss, reflux, and taste problem and presented larger area in global and functional scales and less area in symptom scales, which means that LAPPG tended to present better improvement and less symptoms than LADGBI for QOL 2 years after surgery. Furthermore, LAPPG could bring about significant improvement in total protein and hemoglobin compared to LADGBI at postoperative 2 years.
LAPPG obtains QOL as well as total protein and hemoglobin superiority and could be recommended to patients with EGC whose tumor located in the middle third of the stomach.
本研究旨在探讨中胃早期胃癌患者行腹腔镜辅助保留幽门胃切除术(LAPPG)与腹腔镜辅助毕Ⅰ式胃切除术(LADGBI)的术后生活质量(QOL)。
2015 年 1 月至 2017 年 8 月,在仁济医院共有 91 例 EGC 患者接受了 LAPPG 或 LADGBI 手术,并完成了 QLQ-C30 和 QLQ-STO22 问卷。不仅分析了手术和肿瘤学安全性以及临床病理特征,还比较了 QOL 和营养状况的时间变化,以评估功能优势。
LAPPG 和 LADGBI 两组在临床病理特征和围手术期恢复方面无显著差异。在术后 2 年随访期间,LAPPG 在情绪功能、失眠、食欲减退、反流和味觉问题方面明显优于 LADGBI,在整体和功能量表上面积更大,在症状量表上面积更小,这意味着 LAPPG 在术后 2 年内对 QOL 的改善优于 LADGBI。此外,LAPPG 与 LADGBI 相比,在术后 2 年时总蛋白和血红蛋白水平显著改善。
LAPPG 能获得 QOL 以及总蛋白和血红蛋白的优势,可推荐给肿瘤位于胃中 1/3 处的 EGC 患者。