Long-term quality of life after laparoscopically assisted distal gastrectomy for gastric cancer

Objective: To investigate whether laparoscopically assisted distal gastrectomy (LADG) contributes to long-term quality of life as compared to open gastrectomy in patients with early-stage gastric cancer. Materials and Methods: Quality of life was self-reported using a 15-item questionnaire with five options for each question. The responses obtained from 47 LADG patients and 33 conventional open gastrectomy patients were compared. All patients underwent Billroth I gastrectomy for early gastric cancer between September 1999 and October 2002. Results: Patients who underwent LADG showed better results than those who underwent the open procedure with regard to satisfaction with the operation (87.2% vs. 57.6%; P < 0.01). However, the rate of late complications such as delayed gastric emptying was higher in the LADG group than in the open group (40.4% vs. 18.2%; P < 0.05). No differences were observed between the LADG and open groups with regard to appetite loss, heartburn, diarrhea, or difficulty in swallowing. Conclusion: LADG has an equivocal effect on long-term quality of life. Satisfaction with the surgical procedure was greater in patients who underwent the LADG method; however, complications that impaired the quality of life were also seen. The usefulness of LADG should be assessed in view of the immediate and relatively short-term outcomes and their effect on long-term quality of life.