Examination of the Relationship Between Postoperative Quality of Life and Gastric Emptying Function After Pylorus-Preserving Gastrectomy and Distal Gastrectomy

Abstract

The objective of this study was to compare postoperative quality of life (QOL) of patients with early cancer of the body of the stomach who were treated with pylorus-preserving gastrectomy (PPG) and those treated with distal gastrectomy (DGR), and to evaluate the relationship between postoperative QOL and gastric emptying function (GEF). Patients with early cancer of the body of the stomach are often treated with PPG to preserve gastric function, and their QOL appears to be better after PPG than after DGR. Differences in postoperative GEF are thought to be a factor, but the relationship between GEF and postoperative QOL has not been well investigated. A total of 60 patients [23 PPG and 37 DGR (Billroth I)] completed QOL surveys [SF-36, Gastrointestinal Symptom Rating Scale (GSRS)] and underwent 13C-breath tests to evaluate GEF in two groups (≤12 months postoperatively and >12 months postoperatively). The time until the percentage of breath 13CO2 reaches a peak during the 13C-breath test (Tmax), which is an index of gastric emptying velocity, was evaluated. For the SF-36, there were no significant differences between the two procedures. For GSRS, a trend toward better scores was seen after PPG; abdominal pain and total scores at >12 months postoperatively were significantly better with PPG. Tmax was significantly longer for PPG patients. For each procedure, symptoms significantly worsened when Tmax was <21 minutes at >12 months after surgery. Although postoperative GEF evaluated by 13C-breath tests did not affect overall QOL measured by the SF-36, it did affect disease-specific QOL measured by GSRS.