Brief Articles
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World J Gastroenterol. Jul 7, 2009; 15(25): 3183-3190
Published online Jul 7, 2009. doi: 10.3748/wjg.15.3183
Improved quality of life in patients with gastric cancer after esophagogastrostomy reconstruction
Hao Zhang, Zhe Sun, Hui-Mian Xu, Ji-Xian Shan, Shu-Bao Wang, Jun-Qing Chen
Hao Zhang, Zhe Sun, Hui-Mian Xu, Ji-Xian Shan, Shu-Bao Wang, Jun-Qing Chen, State Key Department of General Surgery, Department of Surgical Oncology, First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
Author contributions: Zhang H and Sun Z conceived of the study, analyzed the data and drafted the manuscript; Xu HM helped revise the manuscript critically for important intellectual content; Xu HM, Shan JX, Wang SB and Chen JQ performed the operation.
Correspondence to: Dr. Hui-Mian Xu, State Key Department of General Surgery, Department of Surgical Oncology, First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China. huimianxu@sina.com
Telephone: +86-24-81792725
Fax: +86-24-23866520
Received: April 20, 2009
Revised: May 20, 2009
Accepted: May 27, 2009
Published online: July 7, 2009
Abstract

AIM: To compare postoperative quality of life (QOL) in patients with gastric cancer treated by esophagogastrostomy reconstruction after proximal gastrectomy.

METHODS: QOL assessments that included functional outcomes (a 24-item survey about treatment-specific symptoms) and health perception (Spitzer QOL Index) were performed in 149 patients with gastric cancer in the upper third of the stomach, who had received proximal gastrectomy with additional esophagogastrostomy.

RESULTS: Fifty-four patients underwent reconstruction by esophagogastric anterior wall end-to-side anastomosis combined with pyloroplasty (EA group); 45 patients had reconstruction by esophagogastric posterior wall end-to-side anastomosis (EP group); and 50 patients had reconstruction by esophagogastric end-to-end anastomosis (EE group). The EA group showed the best postoperative QOL, such as recovery of body weight, less discomfort after meals, and less heart burn or belching at 6 and 24 mo postoperatively. However, the survival rates, surgical results and Spitzer QOL index were similar among the three groups.

CONCLUSION: Postoperative QOL was better in the EA than EP or EE group. To improve QOL after proximal gastrectomy for upper third gastric cancer, the EA procedure using a stapler is safe and feasible for esophagogastrostomy.

Keywords: Gastric cancer; Proximal gastrectomy; Esophagogastrostomy; Quality of life