Quality of Life after Distal Subtotal Gastrectomy by Reconstructive Procedure -Evaluation with Psychological Health Scored by GHQ28-

Yasuko Yoshimura, Kumiko Shirata, Yuko Maeda, Harushi Osugi*, Masashi Takemura*, Shigeru Lee*, Kenichiro Fukuhara* and Hiroshi Iwasaki*

Osaka City University School of Nursing
Department of Gastroenterological Surgery, Osaka City University Graduate School of Medicine*

Aim: The physical condition and quality of life of the patients who had distal subtotal gastrectomy were well studied, however the condition of psychological health of these patients is remained to be evaluated. Patients and methods: The General Health Questionnaire 28 (GHQ28) was used to interview 67 patients without signs of recurrence 12 months or more after distal subtotal gastrectomy and D2 lymph node dissection for gastric cancer. Higher GHQ scores mean poorer psychological health. Information about gastrointestinal symptoms was also obtained. Results: The GHQ score of the patients who underwent Billroth II reconstruction (n=21) was 7.2±5.0 and significantly higher than the scores of the patients who underwent Roux-Y (3.2±3.2, n=27, p<0.01) or Billroth I (3.8±4.6, n=19, p<0.05) reconstruction. At least one gastrointestinal symptom was present in 86% of the patients who underwent Billroth II reconstruction. The incidence of symptoms was significantly higher after Roux-Y (41%, p<0.01). The incidences of bitter reflux, nausea, and diarrhea were significantly higher in the Billroth II group than in the Roux-Y group. Conclusion: In preserving psychological health and reducing postoperative symptoms, Billroth II reconstruction should be avoided, when compared with Roux-Y or Billroth I reconstruction.

Key words
reconstruction procedure after distal subtotal gastrectomy, quality of life, psychological health, General Heath Questionnaire (GHQ), postoperative symptoms

Reprint requests
Yasuko Yoshimura Osaka City University School of Nursing
1-5-17 Asahimachi, Abeno-ku, Osaka, 545-0051 JAPAN

Accepted
September 27, 2006

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