Impact of distal or pylorus preserving gastrectomy on postoperative quality of life in T1 stage middle third gastric cancer patients
Abstract Pylorus-preserving gastrectomy (PPG) and distal gastrectomy (DG) are widely utilized surgical approaches for the treatment of gastric cancer. In this study, we employed questionnaire surveys and follow-up assessments to examine the effects of these surgical procedures on postoperative quali...
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Nature Portfolio
2025-03-01
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| author | Hao Chen Siqing Jing Zhaoping Li Lianlian Cao Wenxian Guan Xin Chen Meng Wang |
| author_facet | Hao Chen Siqing Jing Zhaoping Li Lianlian Cao Wenxian Guan Xin Chen Meng Wang |
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| description | Abstract Pylorus-preserving gastrectomy (PPG) and distal gastrectomy (DG) are widely utilized surgical approaches for the treatment of gastric cancer. In this study, we employed questionnaire surveys and follow-up assessments to examine the effects of these surgical procedures on postoperative quality of life and pancreatic exocrine function in patients with stage T1 middle-third gastric cancer. A retrospective cohort study was conducted to analyze clinical and follow-up data from 63 gastric cancer patients who underwent distal gastrectomy and 21 who underwent pylorus-preserving gastrectomy at Nanjing University Drum Tower Hospital between January 2019 and January 2023. Patients were categorized into two groups: distal gastrectomy (n = 63) and pylorus-preserving gastrectomy (n = 21). The primary outcome measure was postoperative quality of life assessed at 1 year using the Gastric Resection Syndrome Assessment Scale, Gastroparesis Cardinal Symptom Index (GSCI), and Pancreatic Exocrine Insufficiency Questionnaire (PEI-Q). Secondary outcomes included intraoperative and postoperative conditions, incidence of complications, and changes in nutritional status at 6 and 12 months post-surgery. Compared to the DG group, the PPG group exhibited fewer lymph node dissections [20 (17, 26) vs. 25 (19.5, 32), Z = 2.013, P = 0.052], shorter distances from the upper resection margin [2.0 (1.3, 3.0) vs. 3.5 (2.5, 4.75), Z = 4.664, P = 0.0002], and shorter distances from the lower resection margin [2.0 (1.4, 3.0) vs. 4.5 (4.0, 5.5), Z = 6.691, P < 0.001]. However, they experienced longer operative times [270 (240, 300) vs. 220 (187.5, 257.5), Z = 4.133, P = 0.0002], postoperative gas discharge times [4 (4, 5) vs. 4 (3, 4), Z = 5.96, P < 0.0001], and postoperative hospital stays [12 (10, 14) vs. 10 (9, 12), Z = 1.493, P = 0.0098]. One year postoperatively, patients in the PPG group demonstrated superior quality of life scores compared to the DG group in terms of the dumping symptom scale [1.0 (1.0, 1.33) vs. 2.5 (1.75, 2.5), Z = 7.192, P < 0.001], amount of food intake per meal [6 (6, 7) vs. 6 (4, 6), Z = 4.724, P = 0.0008], and meal quality scale [4.0 (3.67, 4.0) vs. 2.33 (1.67, 2.67), Z = 11.554, P < 0.0001]. Additionally, preoperative serum albumin levels were higher in the PPG group compared to the DG group [41.7 (40.3, 43) vs. 40.2 (39.15, 41.3), Z = 2.916, P = 0.006], and the PPG group had a lower rate of postoperative chemotherapy requirement (P = 0.024). Compared to distal gastrectomy (DG), pylorus-preserving gastrectomy (PPG) results in fewer dumping symptoms and an improved quality of life for patients following surgery. This makes PPG a highly favorable surgical option for treating stage T1 middle-third gastric cancer. |
| format | Article |
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| language | English |
| publishDate | 2025-03-01 |
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| spelling | doaj-art-e4c4b1500f8c4e838e3833dba13b754a2025-08-20T03:01:54ZengNature PortfolioScientific Reports2045-23222025-03-011511910.1038/s41598-025-90866-8Impact of distal or pylorus preserving gastrectomy on postoperative quality of life in T1 stage middle third gastric cancer patientsHao Chen0Siqing Jing1Zhaoping Li2Lianlian Cao3Wenxian Guan4Xin Chen5Meng Wang6Division of Gastric Surgery, Department of General Surgery, Affiliated Hospital of Medical School, Nanjing Drum Tower Hospital, Nanjing UniversityDivision of Gastric Surgery, Department of General Surgery, Affiliated Hospital of Medical School, Nanjing Drum Tower Hospital, Nanjing UniversityDivision of Gastric Surgery, Department of General Surgery, Drum Tower Clinical Medical College, Nanjing Drum Tower Hospital, Nanjing University of Chinese MedicineDivision of Gastric Surgery, Department of General Surgery, Drum Tower Clinical Medical College, Nanjing Drum Tower Hospital, Nanjing University of Chinese MedicineDivision of Gastric Surgery, Department of General Surgery, Affiliated Hospital of Medical School, Nanjing Drum Tower Hospital, Nanjing UniversityDivision of Gastric Surgery, Department of General Surgery, Affiliated Hospital of Medical School, Nanjing Drum Tower Hospital, Nanjing UniversityDivision of Gastric Surgery, Department of General Surgery, Affiliated Hospital of Medical School, Nanjing Drum Tower Hospital, Nanjing UniversityAbstract Pylorus-preserving gastrectomy (PPG) and distal gastrectomy (DG) are widely utilized surgical approaches for the treatment of gastric cancer. In this study, we employed questionnaire surveys and follow-up assessments to examine the effects of these surgical procedures on postoperative quality of life and pancreatic exocrine function in patients with stage T1 middle-third gastric cancer. A retrospective cohort study was conducted to analyze clinical and follow-up data from 63 gastric cancer patients who underwent distal gastrectomy and 21 who underwent pylorus-preserving gastrectomy at Nanjing University Drum Tower Hospital between January 2019 and January 2023. Patients were categorized into two groups: distal gastrectomy (n = 63) and pylorus-preserving gastrectomy (n = 21). The primary outcome measure was postoperative quality of life assessed at 1 year using the Gastric Resection Syndrome Assessment Scale, Gastroparesis Cardinal Symptom Index (GSCI), and Pancreatic Exocrine Insufficiency Questionnaire (PEI-Q). Secondary outcomes included intraoperative and postoperative conditions, incidence of complications, and changes in nutritional status at 6 and 12 months post-surgery. Compared to the DG group, the PPG group exhibited fewer lymph node dissections [20 (17, 26) vs. 25 (19.5, 32), Z = 2.013, P = 0.052], shorter distances from the upper resection margin [2.0 (1.3, 3.0) vs. 3.5 (2.5, 4.75), Z = 4.664, P = 0.0002], and shorter distances from the lower resection margin [2.0 (1.4, 3.0) vs. 4.5 (4.0, 5.5), Z = 6.691, P < 0.001]. However, they experienced longer operative times [270 (240, 300) vs. 220 (187.5, 257.5), Z = 4.133, P = 0.0002], postoperative gas discharge times [4 (4, 5) vs. 4 (3, 4), Z = 5.96, P < 0.0001], and postoperative hospital stays [12 (10, 14) vs. 10 (9, 12), Z = 1.493, P = 0.0098]. One year postoperatively, patients in the PPG group demonstrated superior quality of life scores compared to the DG group in terms of the dumping symptom scale [1.0 (1.0, 1.33) vs. 2.5 (1.75, 2.5), Z = 7.192, P < 0.001], amount of food intake per meal [6 (6, 7) vs. 6 (4, 6), Z = 4.724, P = 0.0008], and meal quality scale [4.0 (3.67, 4.0) vs. 2.33 (1.67, 2.67), Z = 11.554, P < 0.0001]. Additionally, preoperative serum albumin levels were higher in the PPG group compared to the DG group [41.7 (40.3, 43) vs. 40.2 (39.15, 41.3), Z = 2.916, P = 0.006], and the PPG group had a lower rate of postoperative chemotherapy requirement (P = 0.024). Compared to distal gastrectomy (DG), pylorus-preserving gastrectomy (PPG) results in fewer dumping symptoms and an improved quality of life for patients following surgery. This makes PPG a highly favorable surgical option for treating stage T1 middle-third gastric cancer.https://doi.org/10.1038/s41598-025-90866-8Pylorus-preserving gastrectomyDistal gastrectomyGastric cancerStomach neoplasmsSurgeryQuality of life |
| spellingShingle | Hao Chen Siqing Jing Zhaoping Li Lianlian Cao Wenxian Guan Xin Chen Meng Wang Impact of distal or pylorus preserving gastrectomy on postoperative quality of life in T1 stage middle third gastric cancer patients Scientific Reports Pylorus-preserving gastrectomy Distal gastrectomy Gastric cancer Stomach neoplasms Surgery Quality of life |
| title | Impact of distal or pylorus preserving gastrectomy on postoperative quality of life in T1 stage middle third gastric cancer patients |
| title_full | Impact of distal or pylorus preserving gastrectomy on postoperative quality of life in T1 stage middle third gastric cancer patients |
| title_fullStr | Impact of distal or pylorus preserving gastrectomy on postoperative quality of life in T1 stage middle third gastric cancer patients |
| title_full_unstemmed | Impact of distal or pylorus preserving gastrectomy on postoperative quality of life in T1 stage middle third gastric cancer patients |
| title_short | Impact of distal or pylorus preserving gastrectomy on postoperative quality of life in T1 stage middle third gastric cancer patients |
| title_sort | impact of distal or pylorus preserving gastrectomy on postoperative quality of life in t1 stage middle third gastric cancer patients |
| topic | Pylorus-preserving gastrectomy Distal gastrectomy Gastric cancer Stomach neoplasms Surgery Quality of life |
| url | https://doi.org/10.1038/s41598-025-90866-8 |
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