Quality of life in patients with esophagojejunal anastomosis after total gastrectomy for cancer.

Objective: To analyze the influence of the esophagojejunostomy type (Roux-en-Y end-to-end or end-to-side, omega, manual or mechanic), of the associated resections and postoperative complications, on patients' Quality of Life (QoL) after total gastrectomy for cancer.

Methods: From 1997 to 2004 63 patients underwent a total gastrectomy for cancer. Patients were invited to fill a questionnaire with 14 treatment-specific related symptoms at 3 and respectively 12 months postoperatively. The present study comprises 39 patients, all without cancer recurrence, who completed all required items.

Results: The QoL was not influenced by the patients' age and gender, associated resections or by the esophagojejunostomy type. Anastomotic fistula significantly influenced patients' appetite at 3 months (p=0.013). At 12 months postoperatively there was a significant difference between the patients' body weight when end-to-end anastomosis were compared to end-to-side anastomosis (p=0.023). The patients' QoL improved in a significant manner at 12 months postoperatively, compared to their QoL at 3 months.

Conclusions: After total gastrectomy for cancer, patients' QoL is not significantly influenced by the type of the esophagojejunostomy. The end-to-end esojejunal anastomosis seems to have a less deleterious effect on the postoperative weight loss. Anastomotic fistula remains the only complication with some influence on patients' QoL in the first postoperative months.