Clinical effect of tubular stomach and whole stomach reconstruction on esophageal carcinoma treatment: A systematic review and meta-analysis
- VernacularTitle:管状胃与全胃重建食管治疗食管癌疗效的系统评价与 Meta 分析
- Author:
Bing WANG
1
,
2
,
3
;
Peijing YAN
4
,
5
,
6
;
Hongxin NIE
7
;
Dacheng JIN
1
,
2
;
Meng CHEN
1
,
2
;
Kehu YANG
4
,
5
,
6
;
Yunjiu GOU
8
Author Information
1. 1. Department of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, 730000, P.R.China
2. 2. Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou, 730000, P.R.China
3. 3. Institution of Clinical Research and Evidence Based Medicine, Gansu Provincial Hospital, Lanzhou, 730000, P.R.China
4. 3. Institution of Clinical Research and Evidence Based Medicine, Gansu Provincial Hospital, Lanzhou, 730000, P.R.China
5. 4. Evidence Based Medicine Center, Lanzhou University, Lanzhou, 730000, P.R.China
6. 5 Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, P.R.China
7. Department of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, 730000, P.R.China
8. Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou, 730000, P.R.China
- Publication Type:Journal Article
- Keywords:
Esophagectomy;
tubular stomach;
whole stomach;
systematic review/meta-analysis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2020;27(05):548-557
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically evaluate the efficacy of tubular stomach and whole stomach reconstruction in the treatment of esophageal cancer. Methods We searched PubMed, Web of Science, The Cochrane Library, EMbase, CNKI, Wanfang Data, VIP and CBM databases to collect the randomized controlled trial (RCT) studies on the efficacy comparison between tubular stomach and total gastric reconstruction of esophagus in esophagectomy from their date of inception to May 2019. Then meta-analysis was performed by using RevMan 5.3 software. Results A total of Twenty-nine RCTs were included, and 3 012 patients were involved. The results of meta-analysis showed that the postoperative complications such as anastomotic fistula [RR=0.64, 95%CI (0.50, 0.83), P=0.000 6], anastomotic stenosis [RR=0.65, 95%CI (0.50, 0.86), P=0.002], thoracic gastric syndrome [RR=0.19, 95%CI (0.13, 0.27), P<0.001], reflux esophagitis [RR=0.23, 95%CI (0.19, 0.30), P<0.001], gastric emptying disorder [RR=0.39, 95%CI (0.27, 0.57), P<0.001] and pulmonary infection [RR=0.44, 95%CI (0.31, 0.62), P<0.001] were significantly reduced, and the postoperative quality of life score and satisfaction were higher at 6 months and 1 year in the tubular stomach group (P<0.05). In terms of intraoperative blood loss and postoperative hospital stay, they were better in the tubular stomach group than those in the whole stomach group (P<0.05). However, there was no statistically significant difference between the two groups in operation time, postoperative gastrointestinal decompression time, postoperative closed drainage time, postoperative 1-year, 2-year and 3-year survival rate, postoperative quality of life score at 3 weeks and 3 months, and postoperative life satisfaction at 3 weeks. Conclusion The tubular stomach is more advantageous than the whole stomach in the reconstruction of esophagus after esophagectomy.
