Double Tract Reconstruction Reduces Reflux Esophagitis and Improves Quality of Life After Radical Proximal Gastrectomy for Patients with Upper Gastric or Esophagogastric Adenocarcinoma

Abstract Background and Aims Routine gastroesophagostomy has been shown to have adverse effects on the recovery of digestive functions and quality of life because patients typically experience reflux symptoms after proximal gastrectomy. This study was performed to assess the feasibility and quality of life benefits of a novel reconstruction method termed Roux-en-Y anastomosis plus antral obstruction (RYAO) following proximal partial gastrectomy. Methods A total of 73 patients who underwent proximal gastrectomy from June 2015 to June 2017 were divided into two groups according to digestive reconstruction methods [RYAO (37 patients) and conventional esophagogastric anastomosis with pyloroplasty (EGPP, 36 patients)]. Clinical data were compared between the two groups retrospectively. Results The mean operative time for digestive reconstruction was slightly longer in the RYAO group than in the EGPP group. However, the incidence of postoperative short-term complications did not differ between the RYAO and the EGPP groups. At the 6-month follow-up, the incidence rates of both reflux esophagitis and gastritis were lower in the RYAO group than in the EGPP group (P = 0.002). Additionally, body weight recovery was better in the RYAO group (P = 0.028). The scale tests indicated that compared with the patients in the EGPP group, the patients in the RYAO group had significantly reduced reflux, nausea and vomiting and reported improvements in their overall health status and quality of life (all P < 0.05). Conclusion RYAO reconstruction may be a feasible procedure to reduce postoperative reflux symptoms and the incidence of reflux esophagitis and gastritis, thus improving patient quality of life after proximal gastrectomy.

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Comparison of laparoscopic proximal gastrectomy with double-tract reconstruction and laparoscopic total gastrectomy in terms of nutritional status or quality of life in early gastric cancer patients

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2018.08.014 ◽

2018 ◽

Vol 44 (12) ◽

pp. 1963-1970 ◽

Cited By ~ 12

Author(s):

Ji Yeon Park ◽

Ki Bum Park ◽

Oh Kyoung Kwon ◽

Wansik Yu

Keyword(s):

Quality Of Life ◽

Gastric Cancer ◽

Early Gastric Cancer ◽

Nutritional Status ◽

Proximal Gastrectomy ◽

Laparoscopic Total Gastrectomy ◽

Double Tract Reconstruction ◽

Laparoscopic Proximal Gastrectomy ◽

Gastric Cancer Patients

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Comparison Of Nutrition And Quality Of Life Of Esophagogastrostomy And The Double-Tract Reconstruction After Laparoscopic Proximal Gastrectomy

10.21203/rs.3.rs-42712/v1 ◽

2020 ◽

Author(s):

Bang Wool Eom ◽

Ji Yeon Park ◽

Ki Bum Park ◽

Hong Man Yoon ◽

Oh Kyoung Kwon ◽

...

Keyword(s):

Quality Of Life ◽

Anastomotic Stricture ◽

Proximal Gastrectomy ◽

Deficiency Anemia ◽

Esophageal Reflux ◽

Double Tract Reconstruction ◽

Significant Difference ◽

Laparoscopic Proximal Gastrectomy ◽

Nutritional Outcomes

Abstract Purpose: This study aims to compare the nutritional outcomes and quality of life between patients who underwent esophagogastrostomy (EG) and those who underwent the double-tract reconstruction (DTR) after laparoscopic proximal gastrectomy for early gastric cancer.Methods: We retrospectively reviewed the prospectively established database of 45 patients who underwent EG with anti-reflux procedure and 58 patients who underwent the DTR after laparoscopic proximal gastrectomy between December 2013 and June 2017. Then, we compared the baseline characteristics, clinical outcomes, postoperative nutritional parameters, and quality of life (QOL) using EORTC QLQ STO-22 between the EG and DTR groups. Results: In the postoperative 1-year endoscopic findings, the incidence of esophageal reflux was higher in the EG group (17.8% vs. 3.4%, p=0.041) and there was no significant difference in anastomotic stricture. Nutritional status was assessed via body mass index, serum albumin, protein, hemoglobin, and ferritin; we found no significant differences. The incidences of iron deficiency anemia and vitamin B12 deficiency also showed no significant difference between the two groups. With regards to the quality of life, the difference values between preoperative and postoperative 1-year were evaluated; there was no significant difference between the EG with anti-reflux procedure and DTR groups. Conclusions: EG had higher incidence of esophageal reflux and similar nutritional outcomes and QOL compared with the double-tract reconstruction after laparoscopic proximal gastrectomy. Additional large-scale research is needed to evaluate the long-term functional outcomes of EG and the double-tract reconstruction.

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Comparison of nutrition and quality of life of esophagogastrostomy and the double-tract reconstruction after laparoscopic proximal gastrectomy

Medicine ◽

10.1097/md.0000000000025453 ◽

2021 ◽

Vol 100 (15) ◽

pp. e25453

Author(s):

Bang Wool Eom ◽

Ji Yeon Park ◽

Ki Bum Park ◽

Hong Man Yoon ◽

Oh Kyoung Kwon ◽

...

Keyword(s):

Quality Of Life ◽

Proximal Gastrectomy ◽

Double Tract Reconstruction ◽

Laparoscopic Proximal Gastrectomy

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Study on the relationship of depression, anxiety, lifestyle and eating habits with the severity of reflux esophagitis

BMC Gastroenterology ◽

10.1186/s12876-021-01717-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rongxin Wang ◽

Jing Wang ◽

Shuiqing Hu

Keyword(s):

Quality Of Life ◽

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Reflux Esophagitis ◽

Eating Habits ◽

Positive Correlation ◽

Relationship Of ◽

The Relationship

Abstract Background The etiology of reflux esophagitis (RE) is multi-factorial. This study analyzed the relationship of depression, anxiety, lifestyle and eating habits with RE and its severity and further explored the impact of anxiety and depression on patients’ symptoms and quality of life. Methods From September 2016 to February 2018, a total of 689 subjects at Xuanwu Hospital Capital Medical University participated in this survey. They were divided into the RE group (patients diagnosed with RE on gastroscopy, n = 361) and the control group (healthy individuals without heartburn, regurgitation and other gastrointestinal symptoms, n = 328). The survey included general demographic information, lifestyle habits, eating habits, comorbidities, current medications, the gastroesophageal reflux disease (GERD) questionnaire (GerdQ), the Patient Health Questionnaire-9 depression scale and the General Anxiety Disorder-7 anxiety scale. Results The mean age and sex ratio of the two groups were similar. Multivariate logistic regression analysis identified the following factors as related to the onset of RE (p < 0.05): low education level; drinking strong tea; preferences for sweets, noodles and acidic foods; sleeping on a low pillow; overeating; a short interval between dinner and sleep; anxiety; depression; constipation; history of hypertension; and use of oral calcium channel blockers. Ordinal logistic regression analysis revealed a positive correlation between sleeping on a low pillow and RE severity (p = 0.025). Depression had a positive correlation with the severity of symptoms (rs = 0.375, p < 0.001) and patients’ quality of life (rs = 0.306, p < 0.001), whereas anxiety showed no such association. Conclusions Many lifestyle factors and eating habits were correlated with the onset of RE. Notably, sleeping on a low pillow was positively correlated with RE severity, and depression was positively related to the severity of symptoms and patients’ quality of life.

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