Background factors influencing postgastrectomy syndromes after various types of gastrectomy.

Abstract

BACKGROUND:

Postgastrectomy syndromes (PGS) after curative gastrectomy for gastric cancer are influenced by not only gastrectomy type but also by background factors. Recently, a nationwide PGS study was performed using the Postgastrectomy Syndrome Assessment Scale-45 (PGSAS-45) questionnaire.

AIM:

To determine the influence of each background factor on PGS for each gastrectomy type using PGS assessment study (PGSAS) data as an additional analysis.

METHODS:

The data of 2368 patients were obtained from the PGSAS. This included patients undergoing distal gastrectomy (DG) with Billroth I reconstruction, DG with Roux-en-Y reconstruction, total gastrectomy with Roux-en-Y, proximal gastrectomy, pylorus-preserving gastrectomy (PPG), and local resection. Multiple regression analysis was performed to explore the independent effects of each background factor on the main outcome measures (MOMs) of PGSAS-45 for each gastrectomy type. The background factors included postoperative period, age, sex, surgical approach (laparoscopic or open), and the status of the celiac branch of the vagal nerve.

RESULTS:

The MOMs of DG and PPG were highly affected by background factors, whereas those of total gastrectomy with Roux-en-Y, proximal gastrectomy, and local resection were not. Worse PGS were found in females, whereas a longer postoperative period alleviated some of the MOMs. For DG and PPG, a laparoscopic approach and preservation of the celiac branch improved several MOMs.

CONCLUSION:

Various background factors affected PGS, and their influence varied with the type of gastrectomy performed. Laparoscopic surgery and celiac branch preservation can improve PGS in patients undergoing DG and PPG.

• Authors: Shinichi Kinami, Masazumi Takahashi, Takashi Urushihara, Masami Ikeda, Masashi Yoshida, Yoshikazu Uenosono, Atsushi Oshio, Yoshimi Suzukamo, Masanori Terashima, Yasuhiro Kodera, Koji Nakada
• Journal: World journal of clinical cases (World J Clin Cases) Vol. 6 Issue 16 Pg. 1111-1120 (Dec 26 2018) ISSN: 2307-8960 [Print] United States
• PMID: 30613669 (Publication Type: Journal Article)