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Evaluation of postoperative quality of life by PGSAS-45 following local gastrectomy based on the sentinel lymph node concept in early gastric cancer

基于前哨淋巴结概念的胃癌局部切除术后 PGSAS-45 生活质量评价

  • 影响因子:4.87
  • DOI:10.1007/s10120-020-01047-7
  • 作者列表:"Okubo, Keishi","Arigami, Takaaki","Matsushita, Daisuke","Sasaki, Ken","Kijima, Takashi","Noda, Masahiro","Uenosono, Yoshikazu","Yanagita, Shigehiro","Ishigami, Sumiya","Maemura, Kosei","Natsugoe, Shoji
  • 发表时间:2020-02-21
Abstract

Background The usefulness of sentinel node navigation surgery (SNNS) for early gastric cancer has been demonstrated in a multicenter prospective study. However, quality of life (QOL) after local resection remains unclear. This present study investigated QOL after local resection and distal gastrectomy. Methods We examined 69 patients who underwent laparoscopic distal gastrectomy (LADG) ( n  = 44) and laparoscopic local resection (LLR) ( n  = 25) in our hospital between September 2011 and May 2018. We conducted a combination of laparoscopic and endoscopic approaches to neoplasia with non-exposure technique (CLEAN-NET) with SNNS as LLR. All patients had pStage I or II and none had received adjuvant chemotherapy. We evaluated QOL using the postgastrectomy syndrome assessment scale questionnaire (PGSAS-45) 1, 6, and 12 months after surgery. Results In PGSAS-45, no significant differences were observed between LLR and LADG at 1 and 6 months after surgery. At 12 months, the LLR group scored better for some of the subscales (SS). In the endoscopic evaluation, the LLR group showed significant improvements in residual gastritis at 6 months ( P  = 0.006) and esophageal reflux and residual gastritis at 12 months ( P  = 0.021 and P  = 0.017). A significant difference was observed in the prognostic nutritional index, which was assessed using serum samples, between the two groups at 6 months ( P  = 0.028). The body weight ratio was better in the LLR group than in the LADG group at 6 and 12 months ( P  = 0.041 and P  = 0.007, respectively). Conclusions CLEAN-NET with SNNS preserved a better QOL and nutrition status than LADG in patients with early gastric cancer.

摘要

背景一项多中心前瞻性研究证实了前哨淋巴结导航手术 (SNNS) 对早期胃癌的有效性。然而,局部切除后的生活质量 (QOL) 仍不清楚。本研究调查了局部切除和远端胃切除术后的 QOL。方法我们检查了 69 例接受腹腔镜远端胃切除术 (LADG) (n = 44) 和腹腔镜局部切除术 (LLR) (n = 25) 的患者。我院于 2011年9月至 2018年5月。我们采用 SNNS 作为 LLR 的非暴露技术 (CLEAN-NET) 进行了腹腔镜和内镜联合手术治疗肿瘤。所有患者均处于 I 期或 II 期,均未接受辅助化疗。我们在术后 1 、 6 和 12 个月使用胃切除术后综合征评估量表问卷 (PGSAS-45) 评估 QOL。结果在 PGSAS-45 中,术后 1 个月和 6 个月的 LLR 和 LADG 之间无显著差异。12 个月时,LLR 组的一些分量表 (SS) 得分较高。在内镜评估中,LLR 组在 6 个月时残留胃炎明显改善 (P = 0.006) 12 个月时食管反流和残余胃炎 (P = 0.021 和 P = 0.017)。在 6 个月时,使用血清样本评估两组之间的预后营养指数存在显著差异 (P = 0.028)。在 6 个月和 12 个月时,LLR 组的体重比优于 LADG 组 (分别为 P = 0.041 和 P = 0.007)。结论与 LADG 相比,SNNS 联合 CLEAN-NET 能更好地保留早期胃癌患者的 QOL 和营养状况。

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影响因子:2.69
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