• Annals of surgery · Jun 2016

    Randomized Controlled Trial

    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.

    • Su Mi Kim, Juhee Cho, Danbee Kang, Seung Jong Oh, Ae Ran Kim, Tae Sung Sohn, Jae Hyoung Noh, and Sung Kim.
    • *Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea†Cancer Education Center, Samsung Medical Center, Sungkyunkwan University School of Medicine and Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea‡Departments of Epidemiology and Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD§Department of Surgery, National Police Hospital, Seoul, Korea¶Department of Nursing, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
    • Ann. Surg. 2016 Jun 1; 263 (6): 1079-84.

    ObjectiveTo 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.DesignRandomized controlled clinical trial.SettingLarge tertiary comprehensive cancer center in Korea.ParticipantsOne hundred sixty-three patients with early gastric cancer 18 years of age or older expected to undergo curative gastric resection.InterventionPatients were randomized 1:1 to VPG (n = 85) or CG (n = 78).Main Outcome MeasuresEuropean Organization for Research and Treatment of Cancer (EORTC) gastric module (STO22).ResultsPatients 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.ConclusionsEarly 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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