Efficacy and safety of proximal gastrectomy versus total gastrectomy for Siewert type Ⅱ and Ⅲ adenocarcinoma of the esophagogastric junction: A systematic review and meta-analysis
- VernacularTitle:近端胃切除与全胃切除治疗SiewertⅡ/Ⅲ型食管胃结合部腺癌疗效及安全性的系统评价与Meta分析
- Author:
Yingjie LU
1
;
Ziqiang HONG
2
;
Hongchao LI
2
;
Gang JIN
3
;
Wenhao WANG
3
;
Yi YANG
3
;
Bin LIU
3
;
Zijiang ZHU
3
Author Information
1. 1. The First Clinical Department of Gansu University of Traditional Chinese Medicine, Lanzhou, 730000, P. R. China 2. Department of Thoracic Surgery Ⅱ, Gansu Provincial Hospital, Lanzhou, 730000, P. R. China
2. The First Clinical Department of Gansu University of Traditional Chinese Medicine, Lanzhou, 730000, P. R. China
3. Department of Thoracic Surgery Ⅱ, Gansu Provincial Hospital, Lanzhou, 730000, P. R. China
- Publication Type:Journal Article
- Keywords:
Adenocarcinoma of the esophagogastric junction;
proximal gastrectomy;
total gastrectomy;
Siewert Ⅱ/Ⅲ;
systematic review/meta-analysis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2025;32(05):693-699
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically evaluate the efficacy and safety of proximal gastrectomy (PG) versus total gastrectomy (TG) for the treatment of Siewert type Ⅱ/Ⅲ adenocarcinoma of the esophagogastric junction (AEG). Methods PubMed, The Cochrane Library, Web of Science, EMbase, CNKI, Wanfang, and VIP databases were searched for literature comparing the efficacy and safety of PG and TG for the treatment of Siewert type Ⅱ/Ⅲ AEG. The search period was from database inception to March 2023. Meta-analysis was performed using Review Manager 5.4 software. Results A total of 23 articles were included, including 16 retrospective cohort studies, 5 prospective cohort studies, and 2 randomized controlled trials. The total sample size was 2 826 patients, with 1 389 patients undergoing PG and 1 437 patients undergoing TG. Meta-analysis results showed that compared with TG, PG had less intraoperative blood loss [MD=−19.85, 95%CI (−37.20, −2.51), P=0.02] and shorter postoperative hospital stay [MD=−1.23, 95%CI (−2.38, −0.08), P=0.04]. TG had a greater number of lymph nodes dissected [MD=−6.20, 95%CI (−7.68, −4.71), P<0.001] and a lower incidence of reflux esophagitis [MD=3.02, 95%CI (1.24, 7.34), P=0.01]. There were no statistically significant differences between the two surgical approaches in terms of operative time, postoperative survival rate (1-year, 3-year, 5-year), and postoperative overall complications (P>0.05). Conclusion PG has advantages in terms of intraoperative blood loss and postoperative hospital stay, while TG has advantages in terms of the number of lymph nodes dissected and the incidence of reflux esophagitis. There is no significant difference in long-term survival between the two surgical approaches.
