title: Quality of life after subtotal gastrectomy for gastric cancer: Does restoration method matter? - A retrospective cohort study.
abstract: BACKGROUND
  The aim of this study was to evaluate the impact on the quality of life (QoL) status of three gastrointestinal continuity restoration methods following a subtotal gastrectomy in patients with gastric cancer.
  
  
  METHODS
  QoL data from 153 patients were obtained and evaluated in this retrospective cross-sectional case series study. A list of patients who responded to questionnaires on QoL was stratified into three arms based on which gastrointestinal continuity restoration method was used - Billroth I (n = 37), Roux-en-Y (n = 15), and Balfour (n = 101).
  
  
  RESULTS
  The mean global health status scores for the patients following the Billroth I, Roux-en-Y and Balfour reconstructive surgery arms were 62 ± 20.09, 61 ± 24.08 and 56 ± 21.2, respectively, (p = 0.182). The mean scores of the functional scales were not lower than 60 in any of the patient groups. For physical, role, cognitive, social functional scales, the Billroth I method had the best mean QoL score. Comparisons of the global QoL, functional activities, and majority of the postgastrectomy symptom scores at different time points after the surgeries (6-12 months vs > 1 year) did not reveal major significant differences between the groups. However, the results highlighted trends and ranked the gastrointestinal continuity restoration methods over time.
  
  
  CONCLUSIONS
  The best QoL scores were obtained from the patients who underwent the Billroth I surgery. The Roux-en-Y method was better than the Balfour method 6-12 months after surgery. However, the Balfour method was better than the Roux-en-Y after one year. Further prospective randomized controlled trials are needed.
authors.affiliation: Vilnius University Hospital Santariskes Clinics, 2 Santariskiu Str, LT-08661, Vilnius, Lithuania.
authors.forename: Edgaras
authors.initials: E
authors.lastname: Smolskas
authors.affiliation: Emergency General Surgery and Major Trauma Centre, General Surgery Department, Aintree University Hospital NHS Foundation Trust, Lower Lane, Liverpool, L9 7AL, United Kingdom.
authors.forename: Raimundas
authors.initials: R
authors.lastname: Lunevicius
authors.affiliation: Clinic of Internal Diseases, Family Medicine and Oncology of Medical Faculty, Institute of Oncology, Vilnius University, 1 Santariskiu Str, LT-08660, Vilnius, Lithuania.
authors.forename: Narimantas Evaldas
authors.initials: NE
authors.lastname: Samalavicius
keywords: Distal gastrectomy; Gastric cancer; Quality of life; Stomach neoplasms