title: Postgastrectomy Syndrome Assessment Scale (PGSAS)-45 and changes in body weight are useful tools for evaluation of reconstruction methods following distal gastrectomy.
abstract: BACKGROUND
  Billroth-I (BI) and Roux-en-Y (RY) are well-known reconstruction methods that are conducted following distal gastrectomy. However, the relative merits of these 2 methods are not well documented. The newly developed Postgastrectomy Syndrome Assessment Scale (PGSAS)-45 is an integrated questionnaire consisting of 45 items, including 8 items from the 8-Item Short-Form Health Survey (SF-8), 15 items from the Gastrointestinal Symptom Rating Scale, and 22 items selected by gastric surgeons. Postoperative QOL ratings were evaluated for each reconstruction method using PGSAS-45.
  
  
  METHODS
  The PGSAS-45 questionnaire was distributed to 2,922 patients who underwent gastrectomies at 52 medical institutions. Among the questionnaires distributed, 2520 (86 %) were retrieved and 2368 (81 %) met eligibility requirements. Statistical analyses were conducted to compare 1,384 of the eligible questionnaires, including responses from patients who underwent BI (n = 909) and RY (n = 475) procedures.
  
  
  RESULTS
  BI procedures were associated with significantly longer postoperative periods, a significantly greater size of gastric remnants, and a higher frequency of laparoscopic approaches and celiac branch preservation. Postoperative QOL analysis indicated that BI procedures resulted in significantly lower postoperative weight loss and significantly higher esophageal reflux symptoms than RY procedures. There was no significant difference between the two groups on other outcome measures.
  
  
  CONCLUSIONS
  Although weight loss was significantly lower following BI procedures, esophageal reflux symptoms were significantly higher. Either BI or RY procedures may be recommended based on the individual patient's condition after distal gastrectomy. The newly developed QOL questionnaire, PGSAS-45 and changes in body weight proved useful for evaluation of QOL following gastrectomy.
authors.affiliation: Division of Gastric Surgery, Shizuoka Cancer Center, Nagaizumi-Cho, Japan, m.terashima@scchr.jp.
authors.forename: Masanori
authors.initials: M
authors.lastname: Terashima
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Tanabe
authors.forename: Masashi
authors.initials: M
authors.lastname: Yoshida
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawahira
authors.forename: Takao
authors.initials: T
authors.lastname: Inada
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okabe
authors.forename: Takashi
authors.initials: T
authors.lastname: Urushihara
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kawashima
authors.forename: Norimasa
authors.initials: N
authors.lastname: Fukushima
authors.forename: Koji
authors.initials: K
authors.lastname: Nakada
mesh_terms: D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects*; D001835:Body Weight; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects*; D005763:Gastroenterostomy / Q000009:adverse effects*; D005764:Gastroesophageal Reflux / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011178:Postgastrectomy Syndromes / Q000175:diagnosis / Q000209:etiology*; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D011379:Prognosis; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D013274:Stomach Neoplasms / Q000601:surgery*; D011795:Surveys and Questionnaires; D015431:Weight Loss; D055815:Young Adult