Quality of life in patients with esophagojejunal anastomosis after total gastrectomy for cancer

Abstract

Objective. To analyze the influence of the esophagojejunostomy type (Roux-en-Y end-to-end or end-to-side, omega, manual or mechanic), of the associated resections and postoperative complications, on patients' Quality of Life (QoL) after total gastrectomy for cancer. Methods. From 1997 to 2004, 63 patients underwent a total gastrectomy for cancer. Patients were invited to fill a questionnaire with 14 treatment-specific related symptoms at 3, and respectively, 12 months postoperatively. The present study comprises 39 patients, all without cancer recurrence, who completed all required items. Results. The QoL was not influenced by the patients' age and gender, associated resections or by the esophagojejunostomy type. Anastomotic fistula significantly influenced patients' appetite at 3 months (p=0.013). At 12 months postoperatively there was a significant difference between the patients' body weight when end-to-end anastomosis was compared to end-to-side anastomosis (p=0.023). The patients' QoL improved in a significant manner at 12 months postoperatively, compared to their QoL at 3 months. Conclusions. After total gastrectomy for cancer, patients' QoL is not significantly influenced by the type of the esophagojejunostomy. The end-to-end esojejunal anastomosis seems to have a less deleterious effect on the postoperative weight loss. Anastomotic fistula remains the only complication with some influence on patients' QoL in the first postoperative months.