title: Determinants of medico-social functioning after total gastrectomy.
abstract: OBJECTIVE
  To describe medico-social functioning after total gastrectomy and the factors determining it.
  
  
  METHODS
  In three medical rehabilitation centres, 173 consecutive patients (female/male = 62/111) after potentially curative total gastrectomy for gastric malignancy 206 days earlier (median, interquartile range = IQR 56-644) were evaluated for different pre- and post-operative parameters with potential influence on post-operative medico-social functioning as measured with the Edinburgh Rehabilitation Status Scale (ERSS). Parameters evaluated were: gender, age, time since operation, tumour stage, type of operation, clinical centre of admittance, haemoglobin, ferritin, albumin, presence of small bowel bacterial overgrowth, rapid oro-coecal transit, dyspepsia, early satiety, reflux, dysphagia, vomiting, a symptom based score, body mass index in health, at operation and on admission, weight loss since operation, calorie intake, bowel habits, and fat malassimilation. Independent influential factors for the ERSS were identified in a linear regression analysis.
  
  
  RESULTS
  The median ERSS-score was 4 (IQR 2-6) on a scale from 0 (best) to 28 (worst). There was a significant difference in the ERSS-scores between the three different clinics. The ERSS-scores improved significantly with time since operation (ca. 22% per year). ERSS-scores were higher in patients with intestino-oesophageal reflux (+71%), with dyspepsia (+65%), or with dysphagia (+62%).
  
  
  CONCLUSIONS
  Medico-social functioning was acceptable in this patient population. After total gastrectomy, dyspepsia, dysphagia, and intestinal reflux into the oesophagus need special attention.
authors.affiliation: Department of Gastroenterology, University Hospital Maastricht, Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Brägelmann
authors.forename: U
authors.initials: U
authors.lastname: Armbrecht
authors.forename: D
authors.initials: D
authors.lastname: Rosemeyer
authors.forename: A
authors.initials: A
authors.lastname: Volovics
authors.forename: W
authors.initials: W
authors.lastname: Zilly
authors.forename: R W
authors.initials: RW
authors.lastname: Stockbrügger
mesh_terms: D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000534:rehabilitation; D005772:Gastrointestinal Transit; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012044:Regression Analysis; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome