scholarly journals A meta-analysis of comparison of proximal gastrectomy with double-tract reconstruction and total gastrectomy for proximal early gastric cancer

2019 ◽  
Author(s):  
Shengnan Li ◽  
Lihu Gu ◽  
Zefeng Shen ◽  
Danyi Mao ◽  
Parikshit Asutosh Khadaroo ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Vitamin B12 ◽  
Total Gastrectomy ◽  
Reflux Esophagitis ◽  
Meta Analysis ◽  
Proximal Gastrectomy ◽  
Cochrane Library ◽  
Clinical Effects ◽  
Double Tract Reconstruction

Abstract Background In theory, proximal gastrectomy with double-tract reconstruction (PG-DT) was superior to total gastrectomy (TG) in hematologic and nutritional outcomes. However, its clinical effects in proximal early gastric cancer (EGC) have been controversial. Methods The purpose of this study was to investigate the outcomes of laparoscopic proximal gastrectomy with double-tract reconstruction (LPG-DT) for proximal EGC. For this systematic review and meta-analysis, we searched for articles published before December of 2018 in the following databases: PubMed, Web of Science, EBSCO, Medline, and Cochrane Library. Results The results showed no significant difference in the anastomotic stenosis (OR=0.91, 95%CI=0.33-2.50, p=0.85) and reflux esophagitis (OR=1.87, 95%CI=0.62-5.65, p=0.27) between LPG-DT and laparoscopic total gastrectomy (LTG). The vitamin B12 supplementation rate in the LPG-DT group was lower than the LTG group (OR=0.06, 95%Cl=0.01-0.59, p=0.02). Conclusions Due to comparable clinical effect, PG-DT is comparable to TG for patients with proximal EGC. In addition, LPG-DT not only appears superior to TG in terms of preventing vitamin B12 deficiency, but also does not increase the risk of anastomotic stricture and reflux esophagitis.

scholarly journals A meta-analysis of comparison of proximal gastrectomy with double-tract reconstruction and total gastrectomy for proximal early gastric cancer

2019 ◽  
Author(s):  
Shengnan Li ◽  
Lihu Gu ◽  
Zefeng Shen ◽  
Danyi Mao ◽  
Parikshit Asutosh Khadaroo ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Vitamin B12 ◽  
Total Gastrectomy ◽  
Reflux Esophagitis ◽  
Meta Analysis ◽  
Proximal Gastrectomy ◽  
Cochrane Library ◽  
Clinical Effects ◽  
Double Tract Reconstruction

Abstract Background In theory, proximal gastrectomy with double-tract reconstruction (PG-DT) was superior to total gastrectomy (TG) in hematologic and nutritional outcomes. However, its clinical effects in proximal early gastric cancer (EGC) have been controversial. Methods The purpose of this study was to investigate the outcomes of laparoscopic proximal gastrectomy with double-tract reconstruction (LPG-DT) for proximal EGC. For this systematic review and meta-analysis, we searched for articles published before December of 2018 in the following databases: PubMed, Web of Science, EBSCO, Medline, and Cochrane Library. Results The results showed no significant difference in the anastomotic stenosis (OR=0.91, 95%CI=0.33-2.50, p=0.85) and reflux esophagitis (OR=1.87, 95%CI=0.62-5.65, p=0.27) between LPG-DT and laparoscopic total gastrectomy (LTG). The vitamin B12 supplementation rate in the LPG-DT group was lower than the LTG group (OR=0.06, 95%Cl=0.01-0.59, p=0.02). Conclusions Due to comparable clinical effect, PG-DT is comparable to TG for patients with proximal EGC. In addition, LPG-DT not only appears superior to TG in terms of preventing vitamin B12 deficiency, but also does not increase the risk of anastomotic stricture and reflux esophagitis.

Proximal gastrectomy versus total gastrectomy for adenocarcinoma of the esophagogastric junction: a meta-analysis

2019 ◽  
Vol 8 (10) ◽  
pp. 753-766 ◽  
Author(s):  
Yi-chuan Chen ◽  
Li Lu ◽  
Kai-hu Fan ◽  
Dao-han Wang ◽  
Wei-hua Fu
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Survival Rate ◽  
Total Gastrectomy ◽  
Recurrence Rate ◽  
Meta Analysis ◽  
Proximal Gastrectomy ◽  
Cochrane Library ◽  
Overall Survival Rate ◽  
Upper Third

Aim: To compare efficacy between total gastrectomy (TG) and proximal gastrectomy (PG) for upper-third gastric cancer. Materials & methods: PubMed, Embase and Cochrane library were searched to select suitable researches. Stata was used for meta-analysis including 5-year overall survival rate, recurrence rate, complication morbidities and serum nutritional levels. Results: Ten retrospective English researches were contained. Our study showed no significant difference of 5-year overall survival rate, recurrence rate, reflux symptoms and anastomotic leakage. TG experienced longer operation time, more lymph nodes-retrieved number, more estimated blood loss and higher ileus, but less anastomotic stricture. PG showed advantages over TG in terms of serum nutritional levels. Conclusion: PG is more preferable to TG for treatment of upper-third gastric cancer.

scholarly journals Clinical Outcomes of Proximal Gastrectomy versus Total Gastrectomy for Proximal Gastric Cancer: A Systematic Review and Meta-Analysis

2020 ◽  
pp. 1-13
Author(s):  
Lulu Zhao ◽  
Rui Ling ◽  
Jinghua Chen ◽  
Anchen Shi ◽  
Changpeng Chai ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Postoperative Complications ◽  
Early Gastric Cancer ◽  
Total Gastrectomy ◽  
Meta Analysis ◽  
Proximal Gastrectomy ◽  
Perioperative Outcomes ◽  
Proximal Gastric Cancer ◽  
Term Survival

<b><i>Introduction:</i></b> The extent of optimal gastric resection for proximal gastric cancer (PGC) continues to remain controversial, and a final consensus is yet to be met. The current study aimed to compare the perioperative outcomes, postoperative complications, and overall survival (OS) of proximal gastrectomy (PG) versus total gastrectomy (TG) in the treatment of PGC through a meta-analysis. <b><i>Methods:</i></b> We systematically searched PubMed, Embase, The Cochrane Library, and Web of Science for articles published in English since database establishment to October 2019. Evaluated endpoints were perioperative outcomes, postoperative complications, and long-term survival outcomes. <b><i>Results:</i></b> A total of 2,896 patients in 25 full-text articles were included, of which one was a prospective randomized study, one was a clinical phase III trial, and the rest were retrospective comparative studies. The PG group showed a higher incidence of anastomotic stenosis (OR = 2.21 [95% CI: 1.08–4.50]; <i>p</i> = 0.03) and reflux symptoms (OR = 3.33 [95% CI: 1.85–5.99]; <i>p</i> &#x3c; 0.001) when compared with the TG group, while no difference was found in PG patients with double-tract reconstruction (DTR). The retrieved lymph nodes were clearly more in the TG group (WMD = −10.46 [95% CI: −12.76 to −8.17]; <i>p</i> &#x3c; 0.001). The PG group was associated with a better 5-year OS relative to TG with 11 included studies (OR = 1.35 [95% CI: 1.03–1.77]; <i>p</i> = 0.03). After stratification for early gastric cancer and PG with DTR groups, however, there was no significant difference between the 2 groups (OR = 1.35 [95% CI: 0.59–2.45]; <i>p</i> = 0.62). <b><i>Conclusion:</i></b> In conclusion, PG was associated with a visible improved long-term survival outcome for all irrespective of tumor stage, while a similar 5-year OS for only early gastric cancer patients between the 2 groups. Future randomized clinical trials of esophagojejunostomy techniques, such as DTR following PG, are expected to prevent postoperative complications and assist surgeons in the choice of surgical approach for PGC patients.

scholarly journals Proximal gastrectomy with double-tract reconstruction versus total gastrectomy for proximal early gastric cancer

Medicine ◽  
2021 ◽  
Vol 100 (45) ◽  
pp. e27818
Author(s):  
Renshen Xiang ◽  
Wei Song ◽  
Jun Ren ◽  
Wei Lu ◽  
Heng Zhang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Total Gastrectomy ◽  
Proximal Gastrectomy ◽  
Double Tract Reconstruction

scholarly journals Reconstruction Methods and Complications of Esophagogastrostomy and Jejunal Interposition in Proximal Gastrectomy for Gastric Cancer: A Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Nan Du ◽  
Pei Wu ◽  
Pengliang Wang ◽  
Yuwei Du ◽  
Kai Li ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lower Risk ◽  
Meta Analysis ◽  
Proximal Gastrectomy ◽  
Operating Time ◽  
Perioperative Period ◽  
Jejunal Interposition ◽  
Cochrane Library ◽  
Reconstruction Methods ◽  
Significant Difference

Background. Proximal gastrectomy is used for the treatment of primary gastric cancer by open or laparoscopic surgery in the upper third of the stomach. Esophagogastrostomy (EG) or jejunal interposition (JI) is widely used in various reconstruction methods after proximal gastrectomy. We conducted a meta-analysis of EG and JI for treatment of gastric cancer. Materials and Methods. A search of PubMed, Embase, MEDLINE, J-STAGE, and Cochrane Library identified retrospective series on EG and JI. Weight mean differences (WMDs), odds ratios (ORs), and 95% confidence intervals (CIs) were used to analyze the operation-related data and postoperative complications. Heterogeneity was evaluated by the I2 test, and potential publication bias was assessed with Egger regression tests and sensitivity analysis. Results. Eight studies were selected, and 496 patients were included. EG group benefits were 44.81 min shorter operating time (P<0.001), 56.58 mL less blood loss (P=0.03), and 7.4 days shorter hospital stay time (P<0.001) than the JI group. Between the two groups, there was no significant difference in anastomotic leakage; otherwise, the EG group had a lower risk of anastomotic stenosis (OR=0.44, 95%CI=0.20 to 0.97, P=0.04), lower risk of intestinal obstruction (OR=0.07, 95%CI=0.01 to 0.43, P=0.004), and higher risk of reflux esophagitis (OR=2.47, 95%CI=1.07 to 5.72, P=0.03). Conclusion. The results of our study indicated that EG has significant advantages during the perioperative period and in short-term outcomes compared to JI.

Sign in / Sign up

Export Citation Format

Share Document