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Meta-Analysis
. 2021 Nov 12;100(45):e27818.
doi: 10.1097/MD.0000000000027818.

Proximal gastrectomy with double-tract reconstruction versus total gastrectomy for proximal early gastric cancer: A systematic review and meta-analysis

Renshen Xiang  1   2 , Wei Song  1   2 , Jun Ren  1   2 , Wei Lu  1   2 , Heng Zhang  1 , Tao Fu  1
Affiliations
Meta-Analysis

Proximal gastrectomy with double-tract reconstruction versus total gastrectomy for proximal early gastric cancer: A systematic review and meta-analysis

Renshen Xiang et al. Medicine (Baltimore). .

Abstract

Background: The incidence of proximal gastric cancer in the gastric fundus, cardia, and other parts is increasing rapidly. The purpose of this study was to systematically compare the short-term and long-term clinical effects of proximal gastrectomy with double tract reconstruction (PG-DTR) to total gastrectomy (TG) for proximal early gastric cancer (EGC).

Methods: A systematic review and meta-analysis was conducted through searching the literature in PubMed, Web of Science, Cochrane Library, EMBASE, CNKI, WAN FANG, and VIP databases. All clinical controlled trials and randomized controlled trials (RCTs) of PG-DTR and PG were included. Simultaneously, the relevant data were extracted, and the software RevMan version 5.1 was used for the meta-analysis.

Results: Eight studies with a total of 753 patients were eligible for the meta-analysis. There were no significant differences in the operation time, intraoperative blood loss, postoperative hospital stay, early complications (anastomotic fistula and anastomotic bleeding), late complications (reflux symptoms and anastomotic stenosis), and 5-year survival rate between PG-DTR and TG. However, the levels of partial nutritional indicators (vitamin B12 supplements and vitamin B12 deficiency) were significantly higher in the PG-DTR group than in the TG group.

Conclusion: This study showed ample evidence to suggest that PG-DTR improved the postoperative nutritional status without compromising patient safety while providing the same surgical characteristics and postoperative morbidity as TG.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1
Figure 1
Flow chart of this study.
Figure 2
Figure 2
Comparison of the number of lymph node dissection between PG-DTR and TG. PG-DTR = proximal gastrectomy combined with double tract reconstruction, TG = total gastrectomy.
Figure 3
Figure 3
Comparison of the incidence of vitamin B12 deficiency between PG-DTR and TG. PG-DTR = proximal gastrectomy combined with double tract reconstruction, TG = total gastrectomy.
Figure 4
Figure 4
Comparison of the number of people taking vitamin B12 supplements between PG-DTR and TG. PG-DTR = proximal gastrectomy combined with double tract reconstruction, TG = total gastrectomy.
Figure 5
Figure 5
The funnel chart of the number of lymph node dissection.
See this image and copyright information in PMC

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