Improved quality of life in patients with gastric cancer after esophagogastrostomy reconstruction

Table 1 Clinicopathological factors of the three groups

Clinicopathological factors	EA group (54)	EP group (45)	EE group (50)	P
Age (yr)	62.5 ± 5.4	56.6 ± 7.6	65.1 ± 8.6	0.668
Gender				0.775
Male	36	29	30
Female	18	16	20
Tumor size (cm)	4.6 ± 1.6	5.0 ± 1.7	4.8 ± 1.3	0.963
Histological type				0.993
Well-differentiated	18	15	17
Moderately differentiated	20	17	19
Poorly differentiated	10	9	8
Signet ring cell type	6	4	6
Lauren’s classification				0.978
Intestinal	30	24	27
Diffuse	18	16	17
Mixed	6	5	6
Lymph node status				0.989
Negative	38	34	36
Positive	16	11	14
Lymphovascular invasion				0.989
Negative	45	38	42
Positive	9	7	8
Stage				0.788
I	17	16	18
II	21	17	20
IIIa	11	7	9
IIIb	5	5	3

Table 2 Surgical results comparison among the three groups

Surgical factors	EA group	EP group	P	EA group	EE group	P	EP group	EE group	P
Additional organ resection			0.609			0.831			0.766
Splenectomy	8	7	0.919	8	7	0.906	7	7	0.832
Splenopancreatectomy	1	2	0.456	1	2	0.515	2	2	0.915
Transverse mesocolectomy	2	2	0.853	2	3	0.586	2	3	0.736
Wedge liver resection	1	1	0.897	1	2	0.515	1	2	0.623
Margin status			0.670			0.938			0.623
Negative	52	44		52	48		44	48
Positive	2	1		2	2		1	2
Lymph node dissection			0.902			0.804			0.721
D1	15	12		15	14		12	14
≥ D2	39	33		39	36		33	36
No. of lymph nodes	29.6 ± 7.6	28.5 ± 6.8	0.524	29.6 ± 7.6	30.1 ± 7.2	0.857	28.5 ± 6.8	30.1 ± 7.2	0.657
Operating time (min)	166.3 ± 47.5	156.8 ± 53.1	0.758	166.3 ± 47.5	149.7 ± 61.2	0.564	156.8 ± 53.1	149.7 ± 61.2	0.265
Blood loss (mL)	263.4 ± 112.6	267.3 ± 121.6	0.273	263.4 ± 112.6	276.9 ± 135.5	0.647	267.3 ± 121.6	276.9 ± 135.5	0.798
Postoperative stay (d)	18.0 ± 5.7	20.9 ± 7.8	0.874	18.0 ± 5.7	19.0 ± 5.7	0.953	20.9 ± 7.8	19.0 ± 5.7	0.849
Postoperative complications	12	11	0.795	12	13	0.654	11	13	0.862
Mortality	0	1	0.273	0	1	0.299	1	1	0.940

Table 3 Comparison of evaluation scores for 6 mo postoperative QOL among the three groups (mean ± SD)

Question	EA group	EP group	P	EA group	EE group	P	EP group	EE group	P
Frequency of eating	0.76 ± 0.799	0.80 ± 0.968	0.957	0.76 ± 0.799	0.78 ± 0.616	0.664	0.80 ± 0.968	0.78 ± 0.616	0.698
Eating time	1.83 ± 0.376	1.58 ± 0.499	0.005a	1.83 ± 0.376	1.42 ± 0.642	0.000a	1.58 ± 0.499	1.42 ± 0.642	0.287
Consistency of food	0.76 ± 0.845	0.71 ± 0.815	0.803	0.76 ± 0.845	0.84 ± 0.792	0.543	0.71 ± 0.815	0.84 ± 0.792	0.391
Volume of food	1.20 ± 0.810	0.60 ± 0.780	0.000a	1.20 ± 0.810	0.58 ± 0.702	0.000a	0.60 ± 0.780	0.58 ± 0.702	0.950
Body weight	0.80 ± 0.711	0.78 ± 0.636	0.969	0.80 ± 0.711	0.66 ± 0.848	0.221	0.78 ± 0.636	0.66 ± 0.848	0.225
Appetite	1.13 ± 0.674	0.87 ± 0.968	0.120	1.13 ± 0.674	1.16 ± 0.817	0.724	0.87 ± 0.968	1.16 ± 0.817	0.118
Difficulty swallowing	1.56 ± 0.664	1.42 ± 0.723	0.333	1.56 ± 0.664	1.54 ± 0.734	0.898	1.42 ± 0.723	1.54 ± 0.734	0.308
Diarrhea	1.83 ± 0.376	1.69 ± 0.733	0.843	1.83 ± 0.376	1.78 ± 0.582	0.852	1.69 ± 0.733	1.78 ± 0.582	0.734
Heartburn or belch	1.37 ± 0.708	0.73 ± 0.863	0.000a	1.37 ± 0.708	0.80 ± 0.756	0.000a	0.73 ± 0.863	0.80 ± 0.756	0.547
Postprandial discomfort	1.46 ± 0.693	1.24 ± 0.957	0.433	1.46 ± 0.693	1.52 ± 0.677	0.646	1.24 ± 0.957	1.52 ± 0.677	0.267
Abdominal pain	1.54 ± 0.770	1.49 ± 0.787	0.721	1.54 ± 0.770	1.60 ± 0.495	0.698	1.49 ± 0.787	1.60 ± 0.495	0.965
Vomiting	1.48 ± 0.771	1.49 ± 0.757	0.993	1.48 ± 0.771	1.68 ± 0.471	0.368	1.49 ± 0.757	1.68 ± 0.471	0.389
General fatigue	1.80 ± 0.528	1.82 ± 0.387	0.792	1.80 ± 0.528	1.92 ± 0.274	0.250	1.82 ± 0.387	1.92 ± 0.274	0.154
Dizziness	1.80 ± 0.562	1.89 ± 0.318	0.687	1.80 ± 0.562	1.74 ± 0.600	0.507	1.89 ± 0.318	1.74 ± 0.600	0.289
Intestinal obstruction	1.65 ± 0.555	1.56 ± 0.693	0.669	1.65 ± 0.555	1.66 ± 0.519	0.997	1.56 ± 0.693	1.66 ± 0.519	0.667
Performance status	1.54 ± 0.719	1.64 ± 0.743	0.240	1.54 ± 0.719	1.58 ± 0.642	0.910	1.64 ± 0.743	1.58 ± 0.642	0.269
Early dumping syndrome	1.54 ± 0.665	1.40 ± 0.720	0.319	1.54 ± 0.665	1.42 ± 0.673	0.307	1.40 ± 0.720	1.42 ± 0.673	0.970
Late dumping syndrome	1.78 ± 0.502	1.73 ± 0.688	0.669	1.78 ± 0.502	1.86 ± 0.452	0.241	1.73 ± 0.688	1.86 ± 0.452	0.532
Physical condition	1.67 ± 0.673	1.80 ± 0.548	0.258	1.67 ± 0.673	1.76 ± 0.517	0.661	1.80 ± 0.548	1.76 ± 0.517	0.450
Wound pain, present	1.57 ± 0.690	1.53 ± 0.815	0.874	1.57 ± 0.690	1.62 ± 0.490	0.809	1.53 ± 0.815	1.62 ± 0.490	0.704
Wound pain, postoperative	1.07 ± 0.866	1.18 ± 0.716	0.600	1.07 ± 0.866	1.22 ± 0.764	0.413	1.18 ± 0.716	1.22 ± 0.764	0.727
Satisfaction with operation	1.57 ± 0.690	1.69 ± 0.557	0.495	1.57 ± 0.690	1.66 ± 0.688	0.357	1.69 ± 0.557	1.66 ± 0.688	0.784
Recommendation to others	1.41 ± 0.714	1.29 ± 0.787	0.484	1.41 ± 0.714	1.46 ± 0.706	0.680	1.29 ± 0.787	1.46 ± 0.706	0.290
Mood or feeling	1.67 ± 0.673	1.67 ± 0.707	0.859	1.67 ± 0.673	1.70 ± 0.463	0.610	1.67 ± 0.707	1.70 ± 0.463	0.507
Total	1.45 ± 0.748	1.36 ± 0.825	0.059	1.45 ± 0.748	1.42 ± 0.743	0.147	1.36 ± 0.825	1.42 ± 0.743	0.389

^aP < 0.05.

Table 4 Comparison of evaluation scores of 24 mo postoperative QOL among the three groups (mean ± SD)

Question	EA group	EP group	P	EA group	EE group	P	EP group	EE group	P
Frequency of eating	1.67 ± 0.583	1.62 ± 0.614	0.711	1.67 ± 0.583	1.70 ± 0.580	0.693	1.62 ± 0.614	1.70 ± 0.580	0.461
Eating time	1.85 ± 0.359	1.78 ± 0.471	0.472	1.85 ± 0.359	1.88 ± 0.328	0.676	1.78 ± 0.471	1.88 ± 0.328	0.273
Consistency of food	1.65 ± 0.619	1.73 ± 0.618	0.306	1.65 ± 0.619	1.80 ± 0.535	0.105	1.73 ± 0.618	1.80 ± 0.535	0.601
Volume of food	1.69 ± 0.639	1.62 ± 0.684	0.613	1.69 ± 0.639	1.70 ± 0.580	0.915	1.62 ± 0.684	1.70 ± 0.580	0.680
Body weight	1.48 ± 0.637	1.13 ± 0.625	0.005a	1.48 ± 0.637	1.14 ± 0.047	0.030a	1.13 ± 0.625	1.14 ± 0.047	0.837
Appetite	1.57 ± 0.662	1.78 ± 0.560	0.056	1.57 ± 0.662	1.70 ± 0.580	0.290	1.78 ± 0.560	1.70 ± 0.580	0.349
Difficulty swallowing	1.52 ± 0.720	1.49 ± 0.787	0.116	1.52 ± 0.720	1.74 ± 0.600	0.059	1.49 ± 0.787	1.74 ± 0.600	0.136
Diarrhea	1.87 ± 0.339	1.80 ± 0.505	0.654	1.87 ± 0.339	1.82 ± 0.523	0.977	1.80 ± 0.505	1.82 ± 0.523	0.658
Heartburn or belch	1.78 ± 0.502	1.73 ± 0.539	0.651	1.78 ± 0.502	1.38 ± 0.805	0.005a	1.73 ± 0.539	1.38 ± 0.805	0.023a
Postprandial discomfort	1.69 ± 0.609	1.07 ± 0.915	0.000a	1.69 ± 0.609	1.22 ± 0.790	0.001a	1.07 ± 0.915	1.22 ± 0.790	0.445
Abdominal pain	1.65 ± 0.649	1.60 ± 0.720	0.848	1.65 ± 0.649	1.70 ± 0.505	0.968	1.60 ± 0.720	1.70 ± 0.505	0.841
Vomiting	1.69 ± 0.577	1.67 ± 0.674	0.814	1.69 ± 0.577	1.70 ± 0.463	0.786	1.67 ± 0.674	1.70 ± 0.463	0.628
General fatigue	1.76 ± 0.581	1.78 ± 0.420	0.626	1.76 ± 0.581	1.84 ± 0.370	0.800	1.78 ± 0.420	1.84 ± 0.370	0.442
Dizziness	1.83 ± 0.505	1.93 ± 0.252	0.410	1.83 ± 0.505	1.80 ± 0.535	0.671	1.93 ± 0.252	1.80 ± 0.535	0.223
Intestinal obstruction	1.78 ± 0.502	1.64 ± 0.679	0.396	1.78 ± 0.502	1.68 ± 0.513	0.204	1.64 ± 0.679	1.68 ± 0.513	0.771
Performance status	1.63 ± 0.653	1.71 ± 0.661	0.322	1.63 ± 0.653	1.70 ± 0.463	0.951	1.71 ± 0.661	1.70 ± 0.463	0.318
Early dumping syndrome	1.70 ± 0.603	1.62 ± 0.650	0.465	1.70 ± 0.603	1.60 ± 0.728	0.560	1.62 ± 0.650	1.60 ± 0.728	0.901
Late dumping syndrome	1.70 ± 0.537	1.73 ± 0.580	0.567	1.70 ± 0.537	1.72 ± 0.479	0.966	1.73 ± 0.580	1.72 ± 0.479	0.594
Physical condition	1.72 ± 0.627	1.64 ± 0.712	0.616	1.72 ± 0.627	1.76 ± 0.476	0.820	1.64 ± 0.712	1.76 ± 0.476	0.753
Wound pain, present	1.83 ± 0.423	1.73 ± 0.580	0.450	1.83 ± 0.423	1.78 ± 0.465	0.494	1.73 ± 0.580	1.78 ± 0.465	0.910
Wound pain, postoperative	1.07 ± 0.866	1.18 ± 0.716	0.600	1.07 ± 0.866	1.22 ± 0.764	0.413	1.18 ± 0.716	1.22 ± 0.764	0.727
Satisfaction with operation	1.72 ± 0.596	1.76 ± 0.484	0.937	1.72 ± 0.596	1.72 ± 0536	0.746	1.76 ± 0.484	1.72 ± 0.536	0.807
Recommendation to others	1.59 ± 0.567	1.42 ± 0.690	0.239	1.59 ± 0.567	1.54 ± 0.646	0.795	1.42 ± 0.690	1.54 ± 0.646	0.382
Mood or feeling	1.63 ± 0.708	1.71 ± 0.695	0.371	1.63 ± 0.708	1.66 ± 0.519	0.634	1.71 ± 0.695	1.66 ± 0.519	0.162
Total	1.67 ± 0.612	1.61 ± 0.663	0.116	1.67 ± 0.612	1.65 ± 0.609	0.150	1.61 ± 0.663	1.65 ± 0.609	0.532

^aP < 0.05.

Table 5 Comparison of evaluation scores of QOL at 6 and 24 mo postoperatively between the same group (mean ± SD)

Question	EA group		P	EP group		P	EE group		P
	6 mo	24 mo		6 mo	24 mo		6 mo	24 mo
Frequency of eating	0.76 ± 0.799	1.67 ± 0.583	0.000a	0.80 ± 0.968	1.62 ± 0.614	0.000a	0.78 ± 0.616	1.70 ± 0.580	0.000a
Eating time	1.83 ± 0.376	1.85 ± 0.359	0.793	1.58 ± 0.499	1.78 ± 0.471	0.031a	1.42 ± 0.642	1.88 ± 0.328	0.000a
Consistency of food	0.76 ± 0.845	1.65 ± 0.619	0.000a	0.71 ± 0.815	1.73 ± 0.618	0.000a	0.84 ± 0.792	1.80 ± 0.535	0.000a
Volume of food	1.20 ± 0.810	1.69 ± 0.639	0.001a	0.60 ± 0.780	1.62 ± 0.684	0.000a	0.58 ± 0.702	1.70 ± 0.580	0.000a
Body weight	0.80 ± 0.711	1.48 ± 0.637	0.000a	0.78 ± 0.636	1.13 ± 0.625	0.010a	0.66 ± 0.848	1.14 ± 0.047	0.004a
Appetite	1.13 ± 0.674	1.57 ± 0.662	0.000a	0.87 ± 0.968	1.78 ± 0.560	0.000a	1.16 ± 0.817	1.70 ± 0.580	0.000a
Difficulty swallowing	1.56 ± 0.664	1.52 ± 0.720	0.890	1.42 ± 0.723	1.49 ± 0.787	0.431	1.54 ± 0.734	1.74 ± 0.600	0.112
Diarrhea	1.83 ± 0.376	1.87 ± 0.339	0.590	1.69 ± 0.733	1.80 ± 0.505	0.823	1.78 ± 0.582	1.82 ± 0.523	0.754
Heartburn or belch	1.37 ± 0.708	1.78 ± 0.502	0.001a	0.73 ± 0.863	1.73 ± 0.539	0.000a	0.80 ± 0.756	1.38 ± 0.805	0.000a
Postprandial discomfort	1.46 ± 0.693	1.69 ± 0.609	0.052	1.24 ± 0.957	1.07 ± 0.915	0.321	1.52 ± 0.677	1.22 ± 0.790	0.048a
Abdominal pain	1.54 ± 0.770	1.65 ± 0.649	0.547	1.49 ± 0.787	1.60 ± 0.720	0.481	1.60 ± 0.495	1.70 ± 0.505	0.241
Vomiting	1.48 ± 0.771	1.69 ± 0.577	0.199	1.49 ± 0.757	1.67 ± 0.674	0.188	1.68 ± 0.471	1.70 ± 0.463	0.830
General fatigue	1.80 ± 0.528	1.76 ± 0.581	0.775	1.82 ± 0.387	1.78 ± 0.420	0.600	1.92 ± 0.274	1.84 ± 0.370	0.221
Dizziness	1.80 ± 0.562	1.83 ± 0.505	0.757	1.89 ± 0.318	1.93 ± 0.252	0.461	1.74 ± 0.600	1.80 ± 0.535	0.585
Intestinal obstruction	1.65 ± 0.555	1.78 ± 0.502	0.138	1.56 ± 0.693	1.64 ± 0.679	0.417	1.66 ± 0.519	1.68 ± 0.513	0.834
Performance status	1.54 ± 0.719	1.63 ± 0.653	0.502	1.64 ± 0.743	1.71 ± 0.661	0.740	1.58 ± 0.642	1.70 ± 0.463	0.498
Early dumping syndrome	1.54 ± 0.665	1.70 ± 0.603	0.114	1.40 ± 0.720	1.62 ± 0.650	0.097	1.42 ± 0.673	1.60 ± 0.728	0.072
Late dumping syndrome	1.78 ± 0.502	1.70 ± 0.537	0.377	1.73 ± 0.688	1.73 ± 0.580	0.538	1.86 ± 0.452	1.72 ± 0.479	0.050
Physical condition	1.67 ± 0.673	1.72 ± 0.627	0.637	1.80 ± 0.548	1.64 ± 0.712	0.259	1.76 ± 0.517	1.76 ± 0.476	0.853
Wound pain, present	1.57 ± 0.690	1.83 ± 0.423	0.031a	1.53 ± 0.815	1.73 ± 0.580	0.326	1.62 ± 0.490	1.78 ± 0.465	0.059
Wound pain, postoperative	1.07 ± 0.866	1.07 ± 0.866	1.000	1.18 ± 0.716	1.18 ± 0.716	1.000	1.22 ± 0.764	1.22 ± 0.764	1.000
Satisfaction with operation	1.57 ± 0.690	1.72 ± 0.596	0.197	1.69 ± 0.557	1.76 ± 0.484	0.597	1.66 ± 0.688	1.72 ± 0536	0.599
Recommendation to others	1.41 ± 0.714	1.59 ± 0.567	0.206	1.29 ± 0.787	1.42 ± 0.690	0.467	1.46 ± 0.706	1.54 ± 0.646	0.606
Mood or feeling	1.67 ± 0.673	1.63 ± 0.708	0.802	1.67 ± 0.707	1.71 ± 0.695	0.636	1.70 ± 0.463	1.66 ± 0.519	0.780
Total	1.45 ± 0.748	1.67 ± 0.612	0.015a	1.36 ± 0.825	1.61 ± 0.663	0.007a	1.42 ± 0.743	1.65 ± 0.609	0.011a

^aP < 0.05.

Table 6 Comparison of evaluation scores of 6 and 24 mo postoperative Spitzer Index among the three groups (mean ± SD)

Factors	EA group	EP group	P	EA group	EE group	P	EP group	EE group	P
6 mo
Activity	1.74 ± 0.556	1.80 ± 0.548	0.403	1.74 ± 0.556	1.76 ± 0.476	0.920	1.80 ± 0.548	1.76 ± 0.476	0.347
Daily living	1.85 ± 0.359	1.78 ± 0.420	0.344	1.85 ± 0.359	1.84 ± 0.422	0.940	1.78 ± 0.420	1.84 ± 0.422	0.326
Health	1.65 ± 0.588	1.62 ± 0.535	0.630	1.65 ± 0.588	1.76 ± 0.517	0.266	1.62 ± 0.535	1.76 ± 0.517	0.115
Support	1.78 ± 0.462	1.71 ± 0.506	0.467	1.78 ± 0.462	1.74 ± 0.487	0.661	1.71 ± 0.506	1.74 ± 0.487	0.767
Outlook	1.76 ± 0.473	1.73 ± 0.539	0.946	1.76 ± 0.473	1.78 ± 0.465	0.790	1.73 ± 0.539	1.78 ± 0.465	0.752
24 mo
Activity	1.72 ± 0.492	1.71 ± 0.506	0.835	1.72 ± 0.492	1.82 ± 0.388	0.674	1.71 ± 0.506	1.82 ± 0.388	0.802
Daily living	1.87 ± 0.339	1.84 ± 0.367	0.714	1.87 ± 0.339	1.90 ± 0.364	0.724	1.84 ± 0.367	1.90 ± 0.364	0.273
Health	1.76 ± 0.473	1.76 ± 0.484	0.352	1.76 ± 0.473	1.90 ± 0.303	0.557	1.76 ± 0.484	1.90 ± 0.303	0.947
Support	1.80 ± 0.451	1.80 ± 0.457	0.367	1.80 ± 0.451	1.84 ± 0.370	0.839	1.80 ± 0.457	1.84 ± 0.370	0.583
Outlook	1.83 ± 0.376	1.76 ± 0.529	0.892	1.83 ± 0.376	1.70 ± 0.614	0.692	1.76 ± 0.529	1.70 ± 0.614	0.793

Table 7 Comparison of evaluation scores of Spitzer Index at 6 and 24 mo postoperatively between the same group (mean ± SD)

Factors	EA group		P	EP group		P	EE group		P
	6 mo	24 mo		6 mo	24 mo		6 mo	24 mo
Activity	1.74 ± 0.556	1.72 ± 0.492	0.583	1.80 ± 0.548	1.71 ± 0.506	0.164	1.76 ± 0.476	1.82 ± 0.388	0.588
Daily living	1.85 ± 0.359	1.87 ± 0.339	0.782	1.78 ± 0.420	1.84 ± 0.367	0.422	1.84 ± 0.422	1.90 ± 0.364	0.350
Health	1.65 ± 0.588	1.76 ± 0.473	0.342	1.62 ± 0.535	1.76 ± 0.484	0.177	1.76 ± 0.517	1.90 ± 0.303	0.148
Support	1.78 ± 0.462	1.80 ± 0.451	0.813	1.71 ± 0.506	1.80 ± 0.457	0.325	1.74 ± 0.487	1.84 ± 0.370	0.301
Outlook	1.76 ± 0.473	1.83 ± 0.376	0.444	1.73 ± 0.539	1.76 ± 0.529	0.807	1.78 ± 0.465	1.70 ± 0.614	0.701