43. Retrospective cohort studied the quality of life after the proximal and total gastrectomy for cancer

Objective: To compare the incidence of reflux, performance statusand the changes of weight after the proximal and total gastrectomy for patients with gastric carcinoma and to choose a more reasonable operation method.
Methods: We collected clinicopathologic features and patients date after surgery in patients who underwent laparoscopic 160 proximal gastrectomy (PG group) and laparoscopy total gastrectomy (TG group) from January 2009 to October 2010. And assessed postoperative complications, body weight changes, the reflux symptom and performance status by GERD questionnaire and ZPS questionnaire, respectively.
Results: TG group (n=317), survival rate was 43.5%, motality was 26.2%, loss rate was 30.3%; PG group (n=113), survival rate was 55.8%, motality was 16.8%, loss rate was 27.4%. The rate of reflux esophagitis (RE) was 14.5% (TG) and 41.3% (PG), respectively. The rate of ZPS scores which was less than or equal to 1 score in TG group was higher than that of PG group (85.5% vs.73%, P=0.034); The rate of complication in PG group was higher than that of TG group (60.3% vs. 22.5%, P<0.01); No difference of the body weight alteration was detected between the two groups.
Conclusions: Compared with the laproscopic proximal gastrectomy, laproscopic total gastrectomy is accompanied with higher quality of life and lower incidence of postoperative complication and should be a better surgical approach for patients with early upper one-third gastric cancer.