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I’m running Pop! OS on a Surface Pro 5 and it works pretty much flawlessly with the Linux Surface kernel installed. That said, 99% of the time I’m using it with the keyboard attached so I haven’t done much testing of it in ‘tablet mode’, nor with a stylus.
From what I’ve seen, there’s no real performance difference with a gaming distro. What they tend to offer is an out of box experience that is more tailored towards gaming than a regular distro (think ‘game mode’, Steam, Proton, and maybe Lutris pre-installed, Nvidia drivers if you need them).