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

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.

SUBMITTER: Li S 

PROVIDER: S-EPMC6704512 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature