Adachi Y, Suematsu T, Shiraishi N, Katsuta T, Morimoto A, Kitano S, Akazawa K
First Department of Surgery, Oita Medical University, Japan.
Ann Surg. 1999 Jan;229(1):49-54. doi: 10.1097/00000658-199901000-00006.
To evaluate the quality of life of patients who had undergone laparoscopy-assisted Billroth I gastrectomy (LAG) for cure of cancer.
In 1994, the authors reported the first case of LAG for early gastric cancer, and this approach quickly has been adopted by Japanese surgeons. However, little is known about the subjective clinical results of this less invasive surgery.
Quality of life was estimated using the 24-item questionnaire with a scoring system of 1, 2, and 3 and was compared between 41 consecutive patients with LAG and 35 with conventional open gastrectomy. All patients underwent Billroth I gastrectomy for early gastric cancer from January 1993 to July 1997 and were alive without recurrence.
Patients who had undergone LAG were taking a normal diet (100%) with >66% of volume at each meal (90%), showed no decreased performance status (90%), and were satisfied with their surgical results (88%). Patients with LAG, when compared with open gastrectomy, showed significantly better results with regard to weight loss, difficulty in swallowing, heartburn and belch, early dumping syndrome, and total score. LAG was better accepted by the patients.
Quality of life after Billroth I gastrectomy was significantly better in patients in whom a laparoscopic technique was used than in those who underwent a conventional method. LAG is less invasive and better accepted by patients and is the procedure of choice for the treatment of early gastric cancer.
评估因癌症行腹腔镜辅助毕罗Ⅰ式胃切除术（LAG）患者的生活质量。
1994年，作者报道了首例早期胃癌的LAG病例，这种方法很快被日本外科医生采用。然而，对于这种微创外科手术的主观临床结果知之甚少。
采用24项问卷，以1、2、3分制评估生活质量，并对41例连续接受LAG手术的患者和35例接受传统开放胃切除术的患者进行比较。所有患者在1993年1月至1997年7月期间因早期胃癌接受毕罗Ⅰ式胃切除术，且均存活无复发。
接受LAG手术的患者饮食正常（100%），每餐进食量超过66%（90%），身体状况无下降（90%），对手术结果满意（88%）。与开放胃切除术相比，LAG患者在体重减轻、吞咽困难、烧心和嗳气、早期倾倒综合征及总分方面的结果明显更好。LAG更易被患者接受。
采用腹腔镜技术的患者毕罗Ⅰ式胃切除术后的生活质量明显优于接受传统手术的患者。LAG创伤较小，更易被患者接受，是早期胃癌治疗的首选术式。
