Quality of Life after Gastrectomy

Česká verzia

Authors: P. Zonča ¹; T. Malý ²; Č. Neoral ²; C. A. Jacobi ¹
Authors place of work: Zentrum für Viszeral und Minimal Invasive Chirurgie, Wesseling, Köln am Rhein, Nordrhein-Westfalen, Německo, přednosta: prof. Dr. med. C. A. Jacobi, Ph. D. ¹; Chirurgická klinika, FN Olomouc, přednosta: doc. MUDr. Č. Neoral, CSc. ²
Published in the journal: Rozhl. Chir., 2010, roč. 89, č. 6, s. 344-348.
Category: Monothematic special - Original

Summary

Aim:
The comparison of quality of life after gastrectomy.

Method:
Quality of life after gastrectomy is compared in open, prospective, randomised trial. The group with Roux-en-Y reconctruction and „J-pouch” reconstruction are compared. „J-pouch” is created using interponate jejunum loop with keeping duodenum in passage. The standardized questionnaire according to Eypasch is tool for comparison of quality life. The statistical evaluation was performed using Student t-test.

Results:
67 patients were analyzed altogether. The average quality of life in the group with Roux-en-Y reconstruction was 92.6 points and in the „J-pouch“ group was 102.5 points. The statistical comparison of quality of life using Student t-test in the group with Roux-en-Y and „J-pouch“ reconstructions confirmed significant difference (p=0,0067).

Conclusion:
Quality of life in patient after gastrectomy represents the most important factors after surgery. The standardised questionnaries help to quantify quality of life and provide the necessary data for evidence based medicine. The statistical comparison confirmed the higher quality of life in patients with „J-pouch“ reconstruction. The possibility of reconstruction providing better nutrition and higher quality of life should be considered.

Key words:
gastrectomy – quality of life

Zdroje

1. Aaronson, N. K., Ahmedzai, S., Bergman, B., et al. 1993, The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J. Natl. Cancer Inst., 8: 365–376.

2. Visick, A. H. A study of the failures after gastrectomy. Ann. R. Coll. Surg. Engl., 1948, Nov; 3(5): 266–284.

3. Korolija, D., Sauerland, S., Wood-Dauphinée, S., Abbou, C. C., Eypasch, E., Caballero, M. G., Lumsden, M. A., Millat, B., Monson, J. R., Nilsson, G., Pointner, R., Schwenk, W., Shamiyeh, A., Szold, A., Targarona, E., Ure, B., Neugebauer, E.; European Association for Endoscopic Surgery Evaluation of quality of life after laparoscopic surgery: evidence-based guidelines of the European Association for Endoscopic Surgery. Surg. Endosc., 2004, Jun; 18(6): 879–897.

4. Eypasch, E., Williams, J. I., Wood-Dauphinee, S., Ure, B. M., Schmülling, C., Neugebauer, E., Troidl, H. Gastrointestinal Quality of Life Index: development, validation and application of a new instrument. Br. J. Surg., 1995, Feb; 82(2): 216–222.

5. Eypasch, E. The individual patient and evidence-based medicine – a conflict? Langenbeck’s Arch. Surg., (1999) 384: 417–422.

6. Feinstein, A. R., Horwitz, R. I. Problems in the “evidence” of “evidencebased medicine”. Am. J. Med., 1997; 103: 529–535.

7. Feyerabend, P., Albert, H. Briefwechsel. Philosophie Fischer, Fischer Verlag, 1997, Frankfurt am Main, p. 183.

8. Schlatter, C. Futher Observations on a case of total extirpation of the stomach in the human subjekt. Lancet, 1898; 2, 1314.

9. Malý, T., Zonča, P., Neoral, Č., Jurytko, A. Post-gastrectomy reconstruction. Rozhl. Chir., 2008, Jul; 87(7): 367–368, 370–375.

10. Aujeský, R., Neoral, Č., Koranda, P. Restoration of digestive passage after total gastrectomy. Rozhl. Chir., 1998, Jan; 77(1): 42–44.

11. Horvath, O. P., Kalmar, K., Cseke, L. Nutritional and life-quality consequences of aboral pouch construction aft er total gastrectomy: a randomized, controlled study. Eur. J. Surg. Oncol., 2001; 27: 558–563.

12. Fein, M., Fuchs, K. H., Thalheimer, A. Long-term benefi ts of Roux-en-Y pouch reconstruction aft er total gastrectomy: a randomized trial. Ann. Surg., 2008; 247: 759–765.

13. Kono, K., Iizuka, H., Sekikawa, T., Sugai, H., Takahashi, A., Fujii, H., Matsumoto, Y. Improved quality of life with jejunal pouch reconstruction after total gastrectomy. Am. J. Surg., 2003, Feb; 185(2): 150–154.

14. Takeshita, K., Sekita, Y., Tani, M. Medium- and long-term results of jejunal pouch reconstruction after a total and proximal gastrectomy. Surg. Today, 2007; 37(9): 754–761.

15. Paimela, H., Ketola, S., Iivonen, M., Tomminen, T., Könönen, E., Oksala, N., Mustonen, H. Long-term results after surgery for gastric cancer with or without jejunal reservoir: results of surgery for gastric cancer in Kanta-Häme central hospital in two consecutive periods without or with jejunal pouch reconstruction in 1985–1998. Intern. J. Gastrointestin. Cancer, 2005; 36(3): 147–153.

16. Shibata, C., Ueno, T., Kakyou, M., Kinouchi, M., Sasaki, I. Results of reconstruction with jejunal pouch after gastrectomy: correlation with gastrointestinal motor activity. Dig. Surg., 2009; 26(3): 177–186.

17. Gertler, R., Rosenberg, R., Feith, M., Schuster, T., Friess, H. Pouch vs. no pouch following total gastrectomy: meta-analysis and systematic review. Am. J. Gastroenterol., 2009, Nov; 104(11): 2838–2851.