title: Quality of life after totalvsdistal gastrectomy with Roux-en-Y reconstruction: Use of the Postgastrectomy Syndrome Assessment Scale-45.
abstract: OBJECTIVE
  To investigate the detrimental impact of loss of reservoir capacity by comparing total gastrectomy (TGRY) and distal gastrectomy with the same Roux-en-Y (DGRY) reconstruction. The study was conducted using an integrated questionnaire, the Postgastrectomy Syndrome Assessment Scale (PGSAS)-45, recently developed by the Japan Postgastrectomy Syndrome Working Party.
  
  
  METHODS
  The PGSAS-45 comprises 8 items from the Short Form-8, 15 from the Gastrointestinal Symptom Rating Scale, and 22 newly selected items. Uni- and multivariate analysis was performed on 868 questionnaires completed by patients who underwent either TGRY (n= 393) or DGRY (n= 475) for stage I gastric cancer (52 institutions). Multivariate analysis weighed of six explanatory variables, including the type of gastrectomy (TGRY/DGRY), interval after surgery, age, gender, surgical approach (laparoscopic/open), and whether the celiac branch of the vagus nerve was preserved/divided on the quality of life (QOL).
  
  
  RESULTS
  The patients who underwent TGRY experienced the poorer QOL compared to DGRY in the 15 of 19 main outcome measures of PGSAS-45. Moreover, multiple regression analysis indicated that the type of gastrectomy, TGRY, most strongly and broadly impaired the postoperative QOL among six explanatory variables.
  
  
  CONCLUSIONS
  The results of the present study suggested that TGRY had a certain detrimental impact on the postoperative QOL, and the loss of reservoir capacity could be a major cause.
authors.affiliation: Masazumi Takahashi, Division of Gastroenterological Surgery, Yokohama Municipal Citizen's Hospital, Yokohama 240-8555, Japan.
authors.forename: Masazumi
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Masazumi Takahashi, Division of Gastroenterological Surgery, Yokohama Municipal Citizen's Hospital, Yokohama 240-8555, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Terashima
authors.affiliation: Masazumi Takahashi, Division of Gastroenterological Surgery, Yokohama Municipal Citizen's Hospital, Yokohama 240-8555, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawahira
authors.affiliation: Masazumi Takahashi, Division of Gastroenterological Surgery, Yokohama Municipal Citizen's Hospital, Yokohama 240-8555, Japan.
authors.forename: Eishi
authors.initials: E
authors.lastname: Nagai
authors.affiliation: Masazumi Takahashi, Division of Gastroenterological Surgery, Yokohama Municipal Citizen's Hospital, Yokohama 240-8555, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Uenosono
authors.affiliation: Masazumi Takahashi, Division of Gastroenterological Surgery, Yokohama Municipal Citizen's Hospital, Yokohama 240-8555, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kinami
authors.affiliation: Masazumi Takahashi, Division of Gastroenterological Surgery, Yokohama Municipal Citizen's Hospital, Yokohama 240-8555, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nagata
authors.affiliation: Masazumi Takahashi, Division of Gastroenterological Surgery, Yokohama Municipal Citizen's Hospital, Yokohama 240-8555, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Yoshida
authors.affiliation: Masazumi Takahashi, Division of Gastroenterological Surgery, Yokohama Municipal Citizen's Hospital, Yokohama 240-8555, Japan.
authors.forename: Keishiro
authors.initials: K
authors.lastname: Aoyagi
authors.affiliation: Masazumi Takahashi, Division of Gastroenterological Surgery, Yokohama Municipal Citizen's Hospital, Yokohama 240-8555, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kodera
authors.affiliation: Masazumi Takahashi, Division of Gastroenterological Surgery, Yokohama Municipal Citizen's Hospital, Yokohama 240-8555, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Nakada
mesh_terms: D000367:Age Factors; D000368:Aged; D000713:Anastomosis, Roux-en-Y; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007564:Japan; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011178:Postgastrectomy Syndromes / Q000209:etiology / Q000523:psychology*; D011184:Postoperative Period; D011788:Quality of Life; D012737:Sex Factors; D013270:Stomach / Q000294:innervation / Q000601:surgery; D013274:Stomach Neoplasms / Q000601:surgery*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014630:Vagus Nerve / Q000601:surgery
keywords: Gastrectomy; Gastric cancer; Patient-reported outcome; Postgastrectomy syndrome; Quality of life