Grosek Jan, Zavrtanik Hana, Tomažič Aleš
Department of Abdominal Surgery, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia.
World J Gastroenterol. 2021 Apr 28;27(16):1816-1827. doi: 10.3748/wjg.v27.i16.1816.
With improved survival in gastric cancer patients, health-related quality of life has become an important clinical endpoint alongside primary oncological outcomes.
To investigate health-related quality of life after various surgical procedures for gastric cancer treatment.
The validated Slovenian version of the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (QLQ-C30) and its gastric cancer-specific module (QLQ STO-22) was sent for self-completion to patients that underwent curative resection for gastric adenocarcinoma between January 2014 and December 2018 at our centre. In total, 116 patients responded. Scores were compared between patients after subtotal distal total gastrectomy and patients after subtotal distal gastrectomy with Billroth II Roux-en-Y reconstruction.
Interestingly, the extent of resection did not influence daily functioning; however, more dysphagia and eating restrictions were reported in patients after total gastrectomy when compared to patients after subtotal distal gastrectomy. Moreover, patients with Billroth II reconstruction after subtotal distal resection experienced worse physical and role functioning and reported more pain, fatigue and reflux compared to Roux-en-Y reconstruction.
Based on our results, Roux-en-Y reconstruction after subtotal distal gastrectomy should be preferred over Billroth II reconstruction. The data obtained from this study will help surgeons when preoperatively informing their patients about expected functional outcomes after gastrectomy and enable them to ensure proper supportive care of their patients in the postoperative period.
随着胃癌患者生存率的提高,与健康相关的生活质量已成为除主要肿瘤学结局之外的重要临床终点。
研究胃癌治疗的各种手术方法后的健康相关生活质量。
将经过验证的斯洛文尼亚语版欧洲癌症研究与治疗组织生活质量核心问卷(QLQ-C30)及其胃癌特异性模块(QLQ STO-22)发送给2014年1月至2018年12月在本中心接受胃腺癌根治性切除术的患者自行填写。共有116名患者做出回应。比较了远端次全胃切除术患者与远端次全胃切除术后行毕罗Ⅱ式吻合术和Roux-en-Y重建术患者的得分。
有趣的是,切除范围并未影响日常功能;然而,与远端次全胃切除术患者相比,全胃切除术患者报告有更多吞咽困难和饮食限制。此外,远端次全切除术后行毕罗Ⅱ式重建术的患者与Roux-en-Y重建术患者相比,身体和角色功能更差,且报告有更多疼痛、疲劳和反流。
根据我们的结果,远端次全胃切除术后Roux-en-Y重建术应优于毕罗Ⅱ式重建术。本研究获得的数据将有助于外科医生在术前告知患者胃切除术后预期的功能结局,并使他们能够在术后确保对患者进行适当的支持性护理。