P1.135. Weight Loss Patterns and Quality of Life After Ivor-Lewis Esophagectomy Versus Proximal Gastrectomy

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ID: 326084
2026
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Ranked #203 of 453 articles by views in diseases of the esophagus : official journal of the international society for diseases of the esophagus

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Abstract
Abstract Topic Esophageal Cancer: Other Background At our institution, surgical procedures for esophagogastric junction cancer (EGJ) are selected based on tumor location and length of esophageal invasion, choosing either Ivor-Lewis esophagectomy (IL) or proximal gastrectomy (PG). To mitigate postoperative weight loss, all patients receive nutritional support with elemental diet supplementation (300 kcal/day) and structured dietary counseling by a registered dietitian before discharge and at 1, 3, 6, and 12 months postoperatively (POM). Quality of life (QOL) is assessed using the Postgastrectomy Syndrome Assessment Scale-37 (PGSAS-37), and results are fed back to patients. Methods To compare postoperative body weight changes and longitudinal trends in PGSAS-37 scores up to 12 months after IL and PG at our institution. Between January 2019 and December 2024, 81 patients underwent IL or PG for esophageal cancer (E), EGJ cancer (EGJ), or gastric cancer (G) (IL: n=51; PG: n=30). After excluding patients with early recurrence within 12 months and those without completed questionnaires, 45 patients were included in the analysis. Extracted variables included patient characteristics, postoperative complications, anastomotic stricture, duration of elemental diet intake (months), body weight loss rate (BWL, %) at 1, 3, 6, and 12 POM, and longitudinal changes in total and symptom-specific PGSAS-37 scores. Results Among 45 eligible patients, 27 underwent IL (E:21, EGJ:6) and 18 underwent PG (EGJ:5, G:13). Median age was 72 in IL and 80 in PG; preoperative BMI was comparable. Neoadjuvant chemotherapy was administered only in IL (n=11). Grade ≥3 complications occurred in 11.1% (IL) and 5.6% (PG), all due to anastomotic leakage. Anastomotic stricture occurred in one patient in each group. Median duration of elemental diet supplementation was longer in IL (4 vs. 1 months). Body weight loss (%) at 1/3/6/12 months was 5.7/8.6/11.4/13.0 in IL and 3.2/7.8/11.1/10.8 in PG. Total PGSAS-37 scores showed similar trends; however, reflux and meal-related distress subscales were generally better in PG. Questionnaire response rates were higher in PG throughout follow-up. Conclusion Both procedures demonstrated rapid weight loss within 3 months postoperatively,suggesting that early postoperative reduction in oral intake may play a greater role than procedural differences in determining weight loss patterns. However, IL was associated with greater weight loss at 12 months and tended to show worse symptom-related QOL scores. Despite longer elemental diet supplementation in the IL group, weight loss progressed, indicating that procedure-specific symptoms and functional limitations may influence long-term nutritional outcomes. In conclusion, although early weight loss trajectories were similar between IL and PG, differences emerged in long-term weight loss and QOL indicators at 12 months.
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Authors Hideki Sunagawa, Hiroshi Okabe, Yuya Takabe
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Journal diseases of the esophagus : official journal of the international society for diseases of the esophagus
Year 2026
DOI
10.1093/dote/doag077.283
URL
https://doi.org/10.1093/dote/doag077.283
Keywords Keywords not found

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