title: Long-term quality-of-life comparison of total gastrectomy and proximal gastrectomy by postgastrectomy syndrome assessment scale (PGSAS-45): a nationwide multi-institutional study.
abstract: BACKGROUND
  Although proximal gastrectomy (PG) is widely accepted as a function-preserving operation for early upper-third gastric cancer, postoperative disorders, such as reflux or gastric stasis, have often been pointed out. From the perspective of postoperative disorder, the choice of total gastrectomy (TG) or PG for such cancers is still controversial. By using the newly developed Postgastrectomy Syndrome Assessment Scale (PGSAS)-45, the quality of life after TG and PG was compared.
  
  
  METHODS
  The PGSAS-45 consists of 45 items composed of the SF-8 and GSRS scales and 22 new items. The main outcomes are measured by seven subscales (SS) covering symptoms, physical and mental component summary (SF-8), meals (amount and quality), ability to work, dissatisfaction for daily life, and change in body weight. A total of 2,368 eligible questionnaires were acquired from 52 institutions. From these, 393 patients with TG and 193 patients with PG were selected and compared.
  
  
  RESULTS
  The PG was better than TG in terms of body weight loss (TG 13.8% vs. PG 10.9%; p = 0.003), necessity for additional meals (2.4 vs. 2.0; p < 0.001), diarrhea SS (2.3 vs. 2.0; p = 0.048), and dumping SS (2.3 vs. 2.0; p = 0.043). There were no differences in the other main outcome measures.
  
  
  CONCLUSIONS
  Proximal gastrectomy appears to be valuable as a function-preserving procedure for early upper-third gastric cancer.
authors.affiliation: Division of Gastroenterological Surgery, Chiba Cancer Center, 666-2 Nitona-cho, Chuo-ku, Chiba, 260-0801, Japan, ntaki@chiba-cc.jp.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Takiguchi
authors.forename: Masazumi
authors.initials: M
authors.lastname: Takahashi
authors.forename: Masami
authors.initials: M
authors.lastname: Ikeda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Inagawa
authors.forename: Shugo
authors.initials: S
authors.lastname: Ueda
authors.forename: Takayuki
authors.initials: T
authors.lastname: Nobuoka
authors.forename: Manabu
authors.initials: M
authors.lastname: Ota
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Iwasaki
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Uchida
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kodera
authors.forename: Koji
authors.initials: K
authors.lastname: Nakada
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011178:Postgastrectomy Syndromes / Q000517:prevention & control*; D011379:Prognosis; D011788:Quality of Life; D012720:Severity of Illness Index; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D011795:Surveys and Questionnaires