Postgastrectomy Syndrome Assessment Scale (PGSAS)-45 and Changes in Body Weight are Useful Tools for Evaluation of Reconstruction Methods Following Distal Gastrectomy
Postgastrectomy Syndrome Assessment Scale (PGSAS)-45 and Changes in Body Weight are Useful Tools for Evaluation of Reconstruction Methods Following Distal Gastrectomy
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DOI：
10.1245/s10434-014-3583-z
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发表时间：
2014-06-01
影响因子：
3.7
通讯作者：
Nakada, Koji
中科院分区：
文献类型：
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作者：
Terashima, Masanori;Tanabe, Kazuaki;Nakada, Koji
Billroth-I(BI)和Roux-en-Y(RY)是远端胃切除术后常用的重建方法。然而，这两种方法的相对优点并没有很好的文献记载。新编制的胃切除术后症状评定量表(PGSAS-45)是一个由45个条目组成的综合性问卷，其中8个条目来自8项简明健康调查(SF-8)，15个条目来自胃肠症状评定量表，22个条目由胃外科医生挑选。采用PGSAS-45对每种重建方法的术后生活质量进行评估，并对52家医疗机构2922例胃切除患者进行问卷调查。在发放的问卷中，收回2520份(86%)，2368份(81%)符合资格要求。统计分析比较了1,384份合格问卷，其中包括接受BI(n=909)和RY(n=475)手术的患者的回答。BI手术与术后时间显著延长、残胃面积显著增大、腹腔镜手术和保留腹部分支的频率更高相关。术后生活质量分析显示，BI组的术后体重减轻显著低于RY组，而食道反流症状明显高于RY组。尽管BI手术后体重减轻显著减少，但食道反流症状显著增加。可根据远端胃切除后患者的情况推荐BI或RY手术。新开发的生活质量问卷、PGSAS-45和体重变化被证明对评估胃切除术后的生活质量是有用的。
Billroth-I (BI) and Roux-en-Y (RY) are well-known reconstruction methods that are conducted following distal gastrectomy. However, the relative merits of these 2 methods are not well documented. The newly developed Postgastrectomy Syndrome Assessment Scale (PGSAS)-45 is an integrated questionnaire consisting of 45 items, including 8 items from the 8-Item Short-Form Health Survey (SF-8), 15 items from the Gastrointestinal Symptom Rating Scale, and 22 items selected by gastric surgeons. Postoperative QOL ratings were evaluated for each reconstruction method using PGSAS-45.The PGSAS-45 questionnaire was distributed to 2,922 patients who underwent gastrectomies at 52 medical institutions. Among the questionnaires distributed, 2520 (86 %) were retrieved and 2368 (81 %) met eligibility requirements. Statistical analyses were conducted to compare 1,384 of the eligible questionnaires, including responses from patients who underwent BI (n = 909) and RY (n = 475) procedures.BI procedures were associated with significantly longer postoperative periods, a significantly greater size of gastric remnants, and a higher frequency of laparoscopic approaches and celiac branch preservation. Postoperative QOL analysis indicated that BI procedures resulted in significantly lower postoperative weight loss and significantly higher esophageal reflux symptoms than RY procedures. There was no significant difference between the two groups on other outcome measures.Although weight loss was significantly lower following BI procedures, esophageal reflux symptoms were significantly higher. Either BI or RY procedures may be recommended based on the individual patient's condition after distal gastrectomy. The newly developed QOL questionnaire, PGSAS-45 and changes in body weight proved useful for evaluation of QOL following gastrectomy.