A Randomized Controlled Trial of Vagus Nerve-preserving Distal Gastrectomy Versus Conventional Distal Gastrectomy for Postoperative Quality of Life in Early Stage Gastric Cancer Patients

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Abstract

Objective:

To compare the postoperative quality of life of vagus nerve preserving distal gastrectomy (VPG) vs conventional distal gastrectomy (CG) in patients with early-stage gastric cancer.

Design:

Randomized controlled clinical trial.

Setting:

Large tertiary comprehensive cancer center in Korea.

Participants:

One hundred sixty-three patients with early gastric cancer 18 years of age or older expected to undergo curative gastric resection.

Intervention:

Patients were randomized 1:1 to VPG (n = 85) or CG (n = 78).

Main outcome measures:

European Organization for Research and Treatment of Cancer (EORTC) gastric module (STO22).

Results:

Patients assigned to VPG showed less diarrhea 3 and 12 months after surgery (P = 0.040 and 0.048, respectively) and less appetite loss at 12 months (P = 0.011) compared with those assigned to CG. In both groups, fatigue, anxiety, eating restriction, and body image deteriorated at 3 months after surgery and did not regain baseline levels 12 months after surgery. There were no significant differences between the 2 groups in cancer recurrence and death over 5 years of follow-up.

Conclusions:

Early gastric cancer patients undergoing VPG reported significantly less diarrhea and appetite loss at 12 months postsurgery compared with those undergoing CG, with no differences in long-term clinical outcomes. VPG may improve the quality of life after gastrectomy in early gastric cancer patients compared with CG.

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