Published online Oct 21, 2017. doi: 10.3748/wjg.v23.i39.7129
Peer-review started: December 9, 2016
First decision: January 10, 2017
Revised: March 22, 2017
Accepted: May 4, 2017
Article in press: May 4, 2017
Published online: October 21, 2017
Processing time: 316 Days and 8.7 Hours
To evaluate the short-term outcomes and quality of life (QoL) in gastric cancer patients undergoing digestive tract construction using the isoperistaltic jejunum-later-cut overlap method (IJOM) after totally laparoscopic total gastrectomy (TLTG).
A total of 507 patients who underwent laparoscopic gastrectomy (D2) from January 2014 to March 2016 were originally included in the study. The patients were divided into two groups to undergo digestive tract construction using either IJOM after TLTG (group T, n = 51) or Roux-en-Y anastomosis after laparoscopic-assisted total gastrectomy (LATG) (group A, n = 456). The short-term outcomes and QoL were compared between the two groups after 1:2 propensity-score matching (PSM). We used a questionnaire to assess QoL.
Before matching, age, sex, tumor size, tumor location, preoperative albumin and blood loss were significantly different between the two groups (P < 0.05). After PSM, the patients were well balanced in terms of their clinicopathological characteristics, although both blood loss and in-hospital postoperative days in group T were significantly lower than those in group A (P < 0.05). After matching, group T reported better QoL in the domains of pain and dysphagia. Among the items evaluating pain and dysphagia, group T tended to report better QoL (“Have you felt pain” and “Have you had difficulty eating solid food”) (P < 0.05).
The IJOM for digestive tract reconstruction after TLTG is associated with reduced blood loss and less pain and dysphagia, thus improving QoL after laparoscopic gastrectomy.
Core tip: This paper used propensity score-matched analysis and questionnaire survey to evaluate the short-term outcomes and quality of life (QoL) in patients who underwent digestive tract reconstruction using the isoperistaltic jejunum-later-cut overlap method (IJOM) after totally laparoscopic total gastrectomy (TLTG) and in patients who underwent Roux-en-Y anastomosis after laparoscopic-assisted total gastrectomy. We found the IJOM for digestive reconstruction after TLTG is associated with reduced blood loss and less pain and dysphagia, thus improving the QoL after laparoscopic gastrectomy.