To 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.
Randomized controlled clinical trial.
Large tertiary comprehensive cancer center in Korea.
One hundred sixty-three patients with early gastric cancer 18 years of age or older expected to undergo curative gastric resection.
Patients were randomized 1:1 to VPG (n = 85) or CG (n = 78).
Main outcome measures:
European Organization for Research and Treatment of Cancer (EORTC) gastric module (STO22).
Patients 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.
Early 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.