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. 2020 Dec;11(12):2863-2872.
doi: 10.1007/s13300-020-00934-7. Epub 2020 Oct 1.

Does Roux-en-Y Construction Really Bring Benefit of Type 2 Diabetes Mellitus Remission After Gastrectomy in Patients with Gastric Cancer? A Systematic Review and Meta-Analysis

Dong Peng  1 , Yu-Xi Cheng  1 , Wei Zhang  2
Affiliations

Does Roux-en-Y Construction Really Bring Benefit of Type 2 Diabetes Mellitus Remission After Gastrectomy in Patients with Gastric Cancer? A Systematic Review and Meta-Analysis

Dong Peng et al. Diabetes Ther. 2020 Dec.

Abstract

Introduction: To evaluate whether the extent of gastrectomy or the reconstruction method brings benefit of type 2 diabetes mellitus (T2DM) remission after gastrectomy in patients with gastric cancer.

Methods: PUBMED, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library were searched to find eligible studies published from inception to July 31, 2020.

Results: A total of nine studies (1424 patients) were included. At the first year and the end of follow-up time after gastrectomy, the total gastrectomy group had better T2DM remission than the subtotal gastrectomy group, and the Roux-en-Y reconstruction (R-Y) group had better T2DM remission compared with the non-R-Y group. There was no difference between R-Y and non-R-Y in terms of subtotal gastrectomy (OR 1.08, 95% CI 0.63-1.84, P = 0.78). However, total gastrectomy with R-Y had better T2DM remission than subtotal gastrectomy with R-Y (OR 2.75, 95% CI 1.19-6.35, P = 0.02).

Conclusion: Total gastrectomy with R-Y had better T2DM remission. The extent of gastrectomy rather than the reconstruction method might play an important role in T2DM remission after gastrectomy in patients with gastric cancer.

Keywords: Gastrectomy; Gastric cancer; Remission; Roux-en-Y reconstruction; Type 2 diabetes mellitus.

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Figures

Fig. 1
Fig. 1
Flowchart of study selection
Fig. 2
Fig. 2
Forest plot showing the outcomes of T2DM remission at the first year after gastrectomy. a Total gastrectomy versus subtotal gastrectomy; b R-Y versus non-R-Y (BI and BII) reconstruction
Fig. 3
Fig. 3
Forest plot showing the outcomes of T2DM remission at the end of follow-up time after gastrectomy. a Total gastrectomy versus subtotal gastrectomy; b R-Y versus non-R-Y (BI and BII) reconstruction
Fig. 4
Fig. 4
Forest plot showing the outcomes of T2DM remission at the end of follow-up time after gastrectomy. a Comparing R-Y between total gastrectomy and subtotal gastrectomy; b comparing R-Y and non-R-Y (BI and BII) in subtotal gastrectomy
Fig. 5
Fig. 5
Funnel plot of total gastrectomy versus subtotal gastrectomy at the end of follow-up time after gastrectomy
See this image and copyright information in PMC

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