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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

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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

Abstract

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.

Figures

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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