J Gastric Cancer.  2014 Mar;14(1):32-38.

Serial Comparisons of Quality of Life after Distal Subtotal or Total Gastrectomy: What Are the Rational Approaches for Quality of Life Management?

• Park S
• Chung HY
• Lee SS
• Kwon O
• Yu W

Abstract

PURPOSE
The aims of this study were to make serial comparisons of the quality of life (QoL) between patients who underwent total gastrectomy and those who underwent distal subtotal gastrectomy for gastric cancer and to identify the affected scales with consistency.
MATERIALS AND METHODS
QoL data of 275 patients who were admitted for surgery between September 2008 and June 2011 and who underwent subtotal gastrectomy or total gastrectomy were obtained preoperatively and postoperatively at 3, 6, 9, 12, 18, and 24 months. The Korean versions of the European Organization for Research and Treatment (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) and the gastric cancer specific module, the EORTC QLQ-STO22, were used to assess QoL.
RESULTS
QoL, as assessed by the global health status/QoL and physical functioning, revealed a brief divergence with worse QoL in the total gastrectomy group 3 months postoperatively, followed by rapid convergence. QoL related to restrictive symptoms (nausea/vomiting, dysphagia, reflux, and eating restrictions) and dry mouth was consistently worse in the total gastrectomy group during the first 2 postoperative years.
CONCLUSIONS
The general QoL of patients after gastrectomy is highly congruent with subjective physical functioning, and the differences between patients who undergo total gastrectomy and subtotal gastrectomy are no longer valid several months after surgery. In order to further reduce the differences in QoL between patients who underwent total gastrectomy and subtotal gastrectomy, definitive preoperative informing, followed by postoperative symptomatic management, of restrictive symptoms in total gastrectomy patients is the most rational approach.

Keyword

Gastrectomy; Quality of life; Stomach neoplasms

MeSH Terms

Deglutition Disorders
Eating
Gastrectomy*
Humans
Mouth
Quality of Life*
Stomach Neoplasms
Weights and Measures
Surveys and Questionnaires

Figure

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  Fig. 1 Serial comparisons of quality of life (QoL) between patients who underwent total gastrectomy (TG) and those who underwent distal subtotal gastrectomy (STG) until the second postoperative year, as assessed by the global health status/QoL and functional scales of the European Organization for Research and Treatment Quality of Life Questionnaire. A higher score represents a better QoL. *P<0.05. †Preoperative QoL scores were set as baseline values by adjusting them to zero.

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  Fig. 2 Serial comparisons of quality of life (QoL) between patients who underwent total gastrectomy (TG) and those who underwent distal subtotal gastrectomy (STG) until the second postoperative year, as assessed by symptom scales/items of the European Organization for Research and Treatment Quality of Life Questionnaire. A higher score represents a worse QoL. *P<0.05. †Preoperative QoL scores were set as baseline values by adjusting them to zero.

• 

  Fig. 3 Serial comparisons of quality of life (QoL) between patients who underwent total gastrectomy (TG) and those who underwent distal subtotal gastrectomy (STG) until the second postoperative year, as assessed by the European Organization for Research and Treatment Quality of Life Questionnaire. A higher score represents a worse QoL. *P<0.05. †Preoperative QoL scores were set as baseline values by adjusting them to zero.

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