Quality of Life After Laparoscopy-Assisted Billroth I Gastrectomy

Adachi, Yosuke; Suematsu, Toshihiro; Shiraishi, Norio; Katsuta, Takeshi; Morimoto, Akio; Kitano, Seigo; Akazawa, Kohei

doi:10.1097/00000658-199901000-00006

Cited by 247 publications

(186 citation statements)

References 17 publications

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“…There have been studies that investigated QoL after LADG. Adachi et al [8] assessed the QoL in patients following LADG and ODSG, using their own questionnaire comprised of 24 questions, with a mean follow-up period of 24 months. That study demonstrated better QoL in patients after LADG regarding weight loss, swallowing difficulty, heartburn and belching, early dumping syndrome, and total score.…”

Section: Discussionmentioning

confidence: 99%

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Quality of life beyond the early postoperative period after laparoscopy-assisted distal gastrectomy: the level of patient expectation as the essence of quality of life

et al. 2011

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Background The aim of this study was to compare the quality of life after the early postoperative period and before reaching 5 years postoperatively between patients who underwent laparoscopy-assisted distal gastrectomy (Group A) and patients who underwent open distal subtotal gastrectomy (Group B). Methods The Korean versions of the European Organization for Research and Treatment (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) and a gastric cancer-specific module, the EORTC QLQ-STO22, were used to assess the quality of life of 80 patients who underwent laparoscopy-assisted distal gastrectomy or open distal subtotal gastrectomy for gastric cancer. The postoperative period ranged between 6 months and 5 years. Results The global health status/quality of life scores of Groups A and B were 56.0 ± 19.0 and 57.4 ± 18.2, respectively (p = 0.729). Group A experienced worse quality of life in role functioning (p = 0.026), cognitive functioning (p = 0.034), fatigue (p = 0.039), eating restrictions (p = 0.009), and anxiety (p = 0.033). Group A showed a trend to experience worse quality of life in physical functioning, emotional functioning, social functioning, insomnia, and body image, albeit without statistical significance. Conclusion After the early postoperative period and before achieving long-term survival, patients who underwent laparoscopy-assisted distal gastrectomy appeared to experience lower quality of life compared to patients who underwent open distal subtotal gastrectomy. This finding may be associated with the patients' erroneously high expectations of laparoscopy-assisted distal gastrectomy.

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Section: Discussionmentioning

confidence: 99%

“…The early postoperative quality of life (QoL) following LADG has been shown to be superior to that following ODSG [8,9]. However, there have been some doubts about the long-term QoL benefits from LADG [10], and Yasuda et al [11] showed that the long-term QoL of patients was similar for LADG and ODSG.…”

Section: Introductionmentioning

confidence: 99%

Quality of life beyond the early postoperative period after laparoscopy-assisted distal gastrectomy: the level of patient expectation as the essence of quality of life

et al. 2011

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“…Many studies have reported early results of LADG's safety and short-term benefits [5][6][7]. In 2015, the long-term results of the KLASS trial will be reported.…”

Section: Introductionmentioning

confidence: 99%

Comparative study of clinical outcomes between laparoscopy-assisted proximal gastrectomy (LAPG) and laparoscopy-assisted total gastrectomy (LATG) for proximal gastric cancer

et al. 2012

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Background The choice of surgical strategy for patients with proximal gastric cancer is controversial. The purpose of this study was to assess the feasibility, safety, and surgical and functional outcomes of laparoscopy-assisted proximal gastrectomy (LAPG) and laparoscopy-assisted total gastrectomy (LATG). Methods Between June 2003 and December 2009, 131 patients with proximal gastric cancer underwent LAPG (n = 50) or LATG (n = 81) at Seoul National University Bundang Hospital. We reviewed their medical and surgical records from our prospectively collected gastric cancer database. The clinicopathologic characteristics and shortterm, long-term, and functional outcomes were compared between the 2 groups. Results There were no significant differences in demographics, T-stage, N-stage, or survival between the 2 groups. The LAPG group had a shorter operative time and lower estimated blood loss than the LATG group. The early complication rates after the LAPG and LATG procedures were 24.0 and 17.3 %, respectively (p = 0.349). The incidence of reflux symptoms was significantly higher in the LAPG group (32.0 vs. 3.7 %, p \ 0.001). The parameters that reflected nutritional status were similar in the 2 groups. Conclusion LAPG is a feasible and acceptable method for treating proximal early gastric cancer in terms of surgical and oncologic safety. However, esophagogastrostomy after LAPG was associated with an increased risk of reflux symptoms. Antireflux procedures should be considered to prevent reflux symptoms after LAPG.

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“…In Japan and Korea, the superiority of laparoscopyassisted gastrectomy (LAG) for early gastric cancer compared with conventional open gastrectomy has been confirmed by both randomized and nonrandomized clinical studies, with advantages including less intraoperative bleeding, less pain, and shorter postoperative hospital stays [4][5][6][7][8][9][10][11][12]. Reported postoperative complication rates are comparable between LAG and conventional open gastrectomy cases.…”

Section: Introductionmentioning

confidence: 99%

Potentially fatal complications for elderly patients after laparoscopy-assisted distal gastrectomy

et al. 2013

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Background The safety of surgery for gastric cancer in the elderly has been shown previously. However, potentially fatal complications based on an established severity grading system were not well described, and associated risk factors have not been assessed. The present study sought to examine severity-dependent postoperative complications after laparoscopy-assisted distal gastrectomy (LADG) in elderly patients and risk factors of potentially fatal postoperative complications. Methods The study included 189 patients aged 70 years or older and who underwent LADG for early gastric cancer. Patient characteristics, perioperative outcomes, postoperative complications including severity assessment using the Clavien-Dindo classification, and risk factors related to postoperative complications were analyzed. Results The overall complication rate was 24.9 % (47/189). The most frequent complication was abdominal fluid collection (9 cases, 4.8 %). Severe complications classified as grade III or above in the Clavien-Dindo grading system were found in 20 (10.6 %) patients. Multivariate analysis identified preoperative serum albumin concentration (odds ratio, 5.200; 95 % CI, 1.706-15.850), Roux-en-Y reconstruction (odds ratio, 3.611; 95 % CI, 1.103-11.817), and simultaneous cholecystectomy (odds ratio, 5.008; 95 % CI, 1.378-18.201) as independent predictors of a higher rate of severe postoperative complications after LADG in elderly patients. Conclusion The incidence of severe complications after LADG in the elderly was quite acceptable considering the risks associated with radical surgery with extensive lymphadenectomy. Preoperative serum concentrations of albumin (\4.0 g/dl), Roux-en-Y reconstruction, and simultaneous cholecystectomy are independent risk factors for severe postoperative complications in these patients.

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Quality of Life After Laparoscopy-Assisted Billroth I Gastrectomy

Cited by 247 publications

References 17 publications

Quality of life beyond the early postoperative period after laparoscopy-assisted distal gastrectomy: the level of patient expectation as the essence of quality of life

Quality of life beyond the early postoperative period after laparoscopy-assisted distal gastrectomy: the level of patient expectation as the essence of quality of life

Comparative study of clinical outcomes between laparoscopy-assisted proximal gastrectomy (LAPG) and laparoscopy-assisted total gastrectomy (LATG) for proximal gastric cancer

Potentially fatal complications for elderly patients after laparoscopy-assisted distal gastrectomy

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