A comparison between pylorus-preserving and distal gastrectomy in surgical safety and functional benefit with gastric cancer: a systematic review and meta-analysis

作者: Xinyu Mao , Xinlei Xu , Hua Zhu , Chunpeng Ji , Xu Lu

DOI: 10.1186/S12957-020-01910-Y

关键词: Bile refluxGastroenterologyRandomized controlled trialMedicineEarly Gastric CancerSurgical oncologyAnastomosisGastrectomyGastric emptyingStrictly standardized mean differenceInternal medicineSurgeryOncology

摘要: Due to better functional outcomes, pylorus-preserving gastrectomy (PPG) has been widely applied for early gastric cancer (EGC) patients as an alternative distal (DG). However, controversies still persist regarding the surgical efficacy and oncological safety of PPG. Original studies comparing PPG DG EGC were searched in PubMed, Embase, Cochrane Register Controlled Trials up December 2019. The weight mean difference, standardized or odds risk was used calculate short-term long-term outcomes between two groups. Twenty-one comparative comprising 4871 (1955 group 2916 group) enrolled this systematic review meta-analysis. showed longer hospital day, decreased harvested lymph nodes, more delayed emptying. had benefits lower incidence anastomosis leakage, dumping syndrome, gastritis bile reflux, recovery total protein, albumin, hemoglobin, weight. No difference found operative time, blood loss, overall complications. Moreover, survival recurrence rate similar Owing non-inferiority surgery oncology superiority function PPG, we revealed that can be clinically applicable instead EGC. high-quality randomized clinical trials would required further confirmation.

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