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Multicenter Study
. 2017 Jul 14;23(26):4823-4830.
doi: 10.3748/wjg.v23.i26.4823.

Predictive Factors for Body Weight Loss and Its Impact on Quality of Life Following Gastrectomy

Free PMC article
Multicenter Study

Predictive Factors for Body Weight Loss and Its Impact on Quality of Life Following Gastrectomy

Kazuaki Tanabe et al. World J Gastroenterol. .
Free PMC article


Aim: To determine the predictive factors and impact of body weight loss on postgastrectomy quality of life (QOL).

Methods: We applied the newly developed integrated questionnaire postgastrectomy syndrome assessment scale-45, which consists of 45 items including those from the Short Form-8 and Gastrointestinal Symptom Rating Scale instruments, in addition to 22 newly selected items. Between July 2009 and December 2010, completed questionnaires were received from 2520 patients with curative resection at 1 year or more after having undergone one of six types of gastrectomy for Stage I gastric cancer at one of 52 participating institutions. Of those, we analyzed 1777 eligible questionnaires from patients who underwent total gastrectomy with Roux-en-Y procedure (TGRY) or distal gastrectomy with Billroth-I (DGBI) or Roux-en-Y (DGRY) procedures.

Results: A total of 393, 475 and 909 patients underwent TGRY, DGRY, and DGBI, respectively. The mean age of patients was 62.1 ± 9.2 years. The mean time interval between surgery and retrieval of the questionnaires was 37.0 ± 26.8 mo. On multiple regression analysis, higher preoperative body mass index, total gastrectomy, and female sex, in that order, were independent predictors of greater body weight loss after gastrectomy. There was a significant difference in the degree of weight loss (P < 0.001) among groups stratified according to preoperative body mass index (< 18.5, 18.5-25 and > 25 kg/m2). Multiple linear regression analysis identified lower postoperative body mass index, rather than greater body weight loss postoperatively, as a certain factor for worse QOL (P < 0.0001) after gastrectomy, but the influence of both such factors on QOL was relatively small (R2, 0.028-0.080).

Conclusion: While it is certainly important to maintain adequate body weight after gastrectomy, the impact of body weight loss on QOL is unexpectedly small.

Keywords: Gastrectomy; Postgastrectomy syndrome assessment scale-45; Quality of life; Weight loss.

Conflict of interest statement

Conflict-of-interest statement: The authors declare no conflicts of interest related to the publication of this study.


Figure 1
Figure 1
CONSORT flowchart of the Postgastrectomy Syndrome Assessment Study (PGSAS study). TGRY: Total gastrectomy with Roux-en-Y reconstruction; DGRY: Distal gastrectomy with Roux-en-Y reconstruction; DGBI: Distal gastrectomy with Billroth-I reconstruction; PPG: Pylorus-preserving gastrectomy; PG: Proximal gastrectomy; LR: Local resection.
Figure 2
Figure 2
Preoperative body mass index strongly influences change in body weight postoperatively. Bars represent the mean change in body weight (mean ± SD); effect size for group difference are reported as Cohen’s d (P < 0.0001). BMI: Body mass index.

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