Published online Nov 27, 2021. doi: 10.4240/wjgs.v13.i11.1484
Peer-review started: April 29, 2021
First decision: June 17, 2021
Revised: June 26, 2021
Accepted: October 31, 2021
Article in press: October 31, 2021
Published online: November 27, 2021
Processing time: 211 Days and 11.4 Hours
Various symptoms that can interfere with the postoperative quality of life (QOL) of patients occur after gastrectomy. The symptoms of defecation disorders, particularly constipation, are relatively modest compared to other postgastrectomy symptoms; therefore, their features and implications on the daily lives of patients have not been adequately investigated.
Several studies have investigated the effect of characteristic postgastrectomy symptoms, such as dumping, small stomach syndrome, and esophageal reflux on the daily lives of patients. However, the implications of symptoms of defecation disorders on patient’s QOL postgastrectomy are poorly understood.
The central goal of this research was to reveal the features of symptoms of defecation disorders and their effects on the daily lives of patients in a large population of gastrectomized patients using the Postgastrectomy Syndrome Assessment Scale (PGSAS)-45, and analyze the data derived using multivariate analysis.
The 1777 patients who underwent total gastrectomy (TG; n = 393) or distal gastrectomy (DG; n = 1384) were enrolled in this study. The severity of defecation disorder symptoms, such as diarrhea and constipation, and their correlation with other postgastrectomy symptoms were examined. The importance of defecation disorder symptoms on the living states and QOL of postgastrectomy patients, and those clinical factors that affect the severity of defecation disorder symptoms were evaluated using multiple regression analysis.
The ranking of defecation disorder symptoms were unexpectedly high in DG among seven symptom subscales of PGSAS-45. There were significant correlation between defecation disorder symptoms and other postgastrectomy symptoms. The defecation disorder symptom, constipation in particular, impaired postgastrectomy living status and QOL. Male sex, younger age, division of the celiac branch of vagus nerve, and TG, independently worsened diarrhea, while female sex worsened constipation.
The severity of symptoms of defecation disorders were unexpectedly high and both symptoms, particularly constipation, impaired the living status and QOL of patients after gastrectomy.
Paying attention to the symptoms of defecation disorders as well as characteristic postgastrectomy symptoms and treating these symptoms adequately may improve the QOL of patients after gastrectomy.