Oh Sung Eun, Suh Yun-Suhk, An Ji Yeong, Ryu Keun Won, Cho In, Kim Sung Geun, Park Ji-Ho, Hur Hoon, Kim Hyung-Ho, Ahn Sang-Hoon, Hwang Sun-Hwi, Yoon Hong Man, Park Ki Bum, Kim Hyoung-Il, Kwon In Gyu, Yang Han-Kwang, Suh Byoung-Jo, Jeong Sang-Ho, Kim Tae-Han, Kwon Oh Kyoung, Ahn Hye Seong, Park Ji Yeon, Yoon Ki Young, Son Myoung Won, Kong Seong-Ho, Son Young-Gil, Song Geum Jong, Yun Jong Hyuk, Bae Jung-Min, Park Do Joong, Lee Sol, Yang Jun-Young, Seo Kyung Won, Jang You-Jin, Kang So Hyun, Eom Bang Wool, Lee Joongyub, Lee Hyuk-Joon
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
J Gastric Cancer. 2025 Apr;25(2):382-399. doi: 10.5230/jgc.2025.25.e26.
This study evaluated the postoperative quality of life (QoL) after various types of gastrectomy for gastric cancer.
A multicenter prospective observational study was conducted in Korea using the Korean Quality of Life in Stomach Cancer Patients Study (KOQUSS)-40, a new QoL assessment tool focusing on postgastrectomy syndrome. Overall, 496 patients with gastric cancer were enrolled, and QoL was assessed at 5 time points: preoperatively and at 1, 3, 6, and 12 months after surgery.
Distal gastrectomy (DG) and pylorus-preserving gastrectomy (PPG) showed significantly better outcomes than total gastrectomy (TG) and proximal gastrectomy (PG) with regard to total score, indigestion, and dysphagia. DG, PPG, and TG also showed significantly better outcomes than PG in terms of dumping syndrome and worry about cancer. Postoperative QoL did not differ significantly according to anastomosis type in DG, except for Billroth I anastomosis, which achieved better bowel habit change scores than the others. No domains differed significantly when comparing double tract reconstruction and esophagogastrostomy after PG. The total QoL score correlated significantly with postoperative body weight loss (more than 10%) and extent of resection (P<0.05 for both). Reflux as assessed by KOQUSS-40 did not correlate significantly with reflux observed on gastroscopy 1 year postoperatively (P=0.064).
Our prospective observation using KOQUSS-40 revealed that DG and PPG lead to better QoL than TG and PG. Further study is needed to compare postoperative QoL according to anastomosis type in DG and PG.
本研究评估了胃癌不同类型胃切除术后的生活质量（QoL）。
在韩国进行了一项多中心前瞻性观察研究，使用韩国胃癌患者生活质量研究（KOQUSS）-40，这是一种专注于胃切除术后综合征的新型QoL评估工具。总共纳入了496例胃癌患者，并在5个时间点评估QoL：术前以及术后1、3、6和12个月。
在总分、消化不良和吞咽困难方面，远端胃切除术（DG）和保留幽门胃切除术（PPG）的结果明显优于全胃切除术（TG）和近端胃切除术（PG）。在倾倒综合征和对癌症的担忧方面，DG、PPG和TG的结果也明显优于PG。在DG中，除了毕罗Ⅰ式吻合术在肠道习惯改变评分方面优于其他吻合术外，术后QoL根据吻合术类型没有显著差异。在PG后比较双通道重建和食管胃吻合术时，各领域没有显著差异。总QoL评分与术后体重减轻（超过10%）和切除范围显著相关（两者P均<0.05）。KOQUSS-40评估的反流与术后1年胃镜观察到的反流没有显著相关性（P = 0.064）。
我们使用KOQUSS-40进行的前瞻性观察表明，DG和PPG比TG和PG带来更好的QoL。需要进一步研究比较DG和PG中不同吻合术类型后的术后QoL。
