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Surgery Today
Published in: Surgery Today 10/2015

01-10-2015 | Original Article

Optimal Roux-en-Y reconstruction after distal gastrectomy for early gastric cancer as assessed using the newly developed PGSAS-45 scale

Authors: Hiroshi Kawahira, Yasuhiro Kodera, Naoki Hiki, Masazumi Takahashi, Seiji Itoh, Norio Mitsumori, Yoshiyuki Kawashima, Tsutomu Namikawa, Takao Inada, Koji Nakada

Published in: Surgery Today | Issue 10/2015

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Abstract

Purpose

The optimal surgical procedure for distal gastrectomy with Roux-en-Y reconstruction (DGRY) remains to be determined. Recently, a self-report assessment instrument, the Postgastrectomy Syndrome Assessment Scale-45 (PGSAS-45), was compiled to evaluate symptoms, the living status and the quality of life of patients who have undergone gastrectomy. We used this scale to evaluate procedures used for DGRY.

Methods

The subjects included 475 patients who underwent DGRY for stage IA/IB gastric cancer. We evaluated whether the size of the remnant stomach, length of the Roux limb, reconstruction route and anastomotic procedure affected the patients’ symptoms, living status and quality of life assessed using the PGSAS-45.

Results

Patients with a residual stomach of more than half had significantly worse esophageal reflux scores than the patients with a smaller residual stomach (P = 0.0462); a residual stomach of one-third or one-fourth was favorable. A shorter length of the Roux limb was shown to be preferable to a longer Roux limb based on the results of the PGSAS-45. In addition, antecolic reconstruction and the anastomotic procedure using a linear stapler were found to be more favorable.

Conclusions

The size of the remnant stomach and the length and route of the Roux limb significantly influence the patient-reported DGRY outcomes.
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Metadata
Title
Optimal Roux-en-Y reconstruction after distal gastrectomy for early gastric cancer as assessed using the newly developed PGSAS-45 scale
Authors
Hiroshi Kawahira
Yasuhiro Kodera
Naoki Hiki
Masazumi Takahashi
Seiji Itoh
Norio Mitsumori
Yoshiyuki Kawashima
Tsutomu Namikawa
Takao Inada
Koji Nakada
Publication date
01-10-2015
Publisher
Springer Japan
Published in
Surgery Today / Issue 10/2015
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-015-1111-9

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