A comparative study of laparoscopic near-total and total gastrectomy for patient nutritional status and quality of life using a propensity score matching analysis

• Published in: Surgical endoscopy Vol. 36; no. 8; pp. 5610 - 5617
• Main Authors: Ko, Chang Seok, Gong, Chung Sik, Kim, Byung Sik, Kim, Seon Ok, Kim, Hee Sung
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-08-2022; Springer Nature B.V
• Subjects: Abdominal Surgery; Gastric cancer; Gastroenterology; Gastrointestinal surgery; Gynecology; Hepatology; Laparoscopy; Medicine; Medicine & Public Health; Nutritional status; Proctology; Quality of life; Surgery; Laparoscopic surgery; Complication; Total gastrectomy; Near-total gastrectomy; Gastric cancer; Quality of life
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s00464-021-08959-0

Background
Previous studies of LNTG had small sample sizes and short follow-up periods and did not evaluate quality of life after LNTG. We aimed to compare surgical, oncological, nutritional outcomes, and quality of life of patients after laparoscopic near-total and total gastrectomy (LNTG and LTG, respectively).
Methods
We retrospectively collected and analyzed data of 167 and 294 patients who underwent LNTG and LTG, respectively, for treatment of upper or middle third gastric cancer between January 2008 and December 2018. After propensity score matching, the surgical, oncological, and nutritional outcomes of 324 patients were analyzed. Moreover, we measured quality of life after surgery using a postgastrectomy syndrome scale.
Results
The operation time and the length of hospital stay was significantly shorter in the LNTG group than in the LTG group. In addition, patients with anastomotic complications were fewer in the LNTG group. No significant difference was found in the 5-year overall survival rate between the two groups. However, patients in the LNTG group had a significantly smaller body weight loss after 3 months postoperatively. Furthermore, patients in the LNTG group had significantly healthier albumin and cholesterol than those in the LTG group. The mean scores on the postgastrectomy symptom scale at 3, 6, and 12 months postoperatively were higher in the LNTG group than in the LTG group.
Conclusion
LNTG is a surgically safe and oncologically favorable method compared with LTG. Furthermore, patients who underwent LNTG had improved nutritional status and quality of life than those who underwent LTG.