STUDY FOR ON THE QUALITY OF LIFE IN PATIENTS UNDERGONE ILEO-COLIC INTERPOSITION AFTER PROXIMAL GASTRECTOMY FOR UPPER-HALF GASTRIC CANCER

Abstract

Some problems still lie in the quality of life for the patients undergone proximal gastrectomy for the upper gastric cancer. Because there are some postoperative complications, such as reflux esophagitis. The aim of this study was to examine whether an extended proximal gastrectomy including D2 lymph node dissection reconstructed with a normoperistaltically aligned insertion of an ileocolic segment reduced postoperative complications or improved the quality of life. Subjects were six patients including four men and two women. To know the quality of life, a questionnaire survey asking about postoperative unpleasant symptoms was conducted more than 1 year after the surgery. Endoscopic findings, esophageal manometric study, body weight, amount of feeding and laboratory data were also investigated until postoperative one year. Postoperative endoscopy did not show any findings of esophagitis in all the patients. In contrast to patients with total gastrectomy, a lower esophageal high pressure zone newly constructed by ileocecal valve was detected in each patient in the esophageal manometric study. The body weight loss at one year after the surgery was 7.1% as compared with the postoperative body weight. The amount of feeding was restored to 95.0% of that of before surgery. All the laboratory data after the surgery were within normal range. It is consequently concluded that the extended proximal gastrectomy including D2 lymph node dissection reconstructed with an insertion of an ileocolic segment is a prominent method for the patients with early or proper muscle cancers located at the upper half of the stomach.