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Evaluation of QOL After Proximal Gastrectomy Using a Newly Developed Assessment Scale (PGSAS-45)

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Abstract

Background

Proximal gastrectomy with esophagogastrostomy (PGEG) has been widely applied as a comparatively simple method. In this study, we used a questionnaire survey to evaluate the influence of various surgical factors on post-operative quality of life (QOL) after PGEG.

Methods

In this post-gastrectomy syndrome assessment study, we analyzed QOL in 2,368 cases. Among these, 193 had undergone proximal gastrectomy and 115 had undergone PGEG. The Post-Gastrectomy Syndrome Assessment Scale (PGSAS)-45 is a questionnaire consisting of 45 items, including the SF-8, the Gastrointestinal Symptom Rating Scale (GSRS), and other symptom items seemed to be specific to post-gastrectomy. The 23 symptom items were composed of seven symptom subscales (SS), including esophageal reflux, abdominal pain, and meal-related distress. These seven SS, total symptom score, ingested amount of food per meal, necessity for additional meals, quality of ingestion SS, ability to work, dissatisfaction with symptoms, dissatisfaction with the meal, dissatisfaction with working, dissatisfaction with daily life SS and change in body weight were evaluated as main outcome measures. In PGEG cases, we evaluated the influence on QOL of various surgical factors, such as procedures to prevent gastroesophageal regurgitation and size of the remnant stomach.

Results

The scores for esophageal reflux and dissatisfaction with the meal were higher in patients who had not undergone an anti-reflux procedure. In most cases, the preserved remnant stomach was more than two-thirds the size of the pre-operative stomach. When comparing patients with a remnant stomach two-thirds the pre-operative size and those with more than three-quarters, the diarrhea SS and necessity for additional meals scores were lower in the group with more than three-quarters. The indigestion, constipation, and abdominal pain subscales, and the total symptom score, were higher in patients who had not undergone pyloric bougie than in those who had.

Conclusion

These results indicated that QOL was better in patients with a large remnant stomach. Procedures to prevent gastroesophageal reflux, and the use of pyloric bougie as a complementary drainage procedure, were considered effective ways to reduce the deterioration of QOL.

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Conflict of interest

The authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Surgery, Tochigi Cancer Center, Utsunomiya, Japan

    Takao Inada

  2. Center of Digestive Diseases, International University of Health and Welfare Mita Hospital, Tokyo, Japan

    Masashi Yoshida

  3. Department of Surgery, Asama General Hospital, Saku, Japan

    Masami Ikeda

  4. Department of Surgery, Osaka Kosei-Nenkin Hospital, Osaka, Japan

    Takeyoshi Yumiba

  5. Department of Digestive Surgery, Kawasaki Medical School, Kurashiki, Japan

    Hideo Matsumoto

  6. Department of Surgery, Hakodate Goryokaku Hospital, Hakodate, Japan

    Akinori Takagane

  7. Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan

    Chikara Kunisaki

  8. Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan

    Ryoji Fukushima

  9. Department of Surgery, Niigata Cancer Center Hospital, Niigata, Japan

    Hiroshi Yabusaki

  10. Department of Surgery, Jikei University, School of Medicine, Tokyo, Japan

    Koji Nakada

  11. Japan Postgastrectomy Syndrome Working Party, Tokyo, Japan

    Takao Inada, Masashi Yoshida, Masami Ikeda, Takeyoshi Yumiba, Hideo Matsumoto, Akinori Takagane, Chikara Kunisaki, Ryoji Fukushima, Hiroshi Yabusaki & Koji Nakada

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  1. Takao Inada
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  2. Masashi Yoshida
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  3. Masami Ikeda
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  4. Takeyoshi Yumiba
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  5. Hideo Matsumoto
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  6. Akinori Takagane
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  7. Chikara Kunisaki
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  8. Ryoji Fukushima
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  9. Hiroshi Yabusaki
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  10. Koji Nakada
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Corresponding author

Correspondence to Takao Inada.

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Inada, T., Yoshida, M., Ikeda, M. et al. Evaluation of QOL After Proximal Gastrectomy Using a Newly Developed Assessment Scale (PGSAS-45). World J Surg 38, 3152–3162 (2014). https://doi.org/10.1007/s00268-014-2712-y

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  • DOI: https://doi.org/10.1007/s00268-014-2712-y

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