Tags

Type your tag names separated by a space and hit enter

A comparison between pylorus-preserving and distal gastrectomy in surgical safety and functional benefit with gastric cancer: a systematic review and meta-analysis.
World J Surg Oncol. 2020 Jul 08; 18(1):160.WJ

Abstract

BACKGROUND

Due to better functional outcomes, pylorus-preserving gastrectomy (PPG) has been widely applied for early gastric cancer (EGC) patients as an alternative to distal gastrectomy (DG). However, controversies still persist regarding the surgical efficacy and oncological safety of PPG.

METHODS

Original studies comparing PPG and DG for EGC were searched in PubMed, Embase, and the Cochrane Register of Controlled Trials up to December 2019. The weight mean difference, standardized mean difference, or odds risk was used to calculate the short-term and long-term outcomes between the two groups.

RESULTS

Twenty-one comparative studies comprising 4871 patients (1955 in the PPG group and 2916 in the DG group) were enrolled in this systematic review and meta-analysis. PPG showed longer hospital day, decreased harvested lymph nodes, and more delayed gastric emptying. However, PPG had the benefits of lower incidence of anastomosis leakage, early dumping syndrome, gastritis and bile reflux, and better recovery of total protein, albumin, hemoglobin, and weight. No difference was found in operative time, blood loss, and overall complications. Moreover, the long-term survival and recurrence rate were similar in two groups.

CONCLUSION

Owing to the non-inferiority of surgery and oncology outcomes and the superiority of function outcomes in PPG, we revealed that PPG can be clinically applicable instead of DG in EGC. However, more high-quality comparative studies and randomized clinical trials would be required for further confirmation.

Authors+Show Affiliations

Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University, 121 Jiangjiayuan Road, Nanjing, 210011, Jiangsu, China.Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University, 121 Jiangjiayuan Road, Nanjing, 210011, Jiangsu, China.Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University, 121 Jiangjiayuan Road, Nanjing, 210011, Jiangsu, China.Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University, 121 Jiangjiayuan Road, Nanjing, 210011, Jiangsu, China.Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University, 121 Jiangjiayuan Road, Nanjing, 210011, Jiangsu, China.Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University, 121 Jiangjiayuan Road, Nanjing, 210011, Jiangsu, China. wangbl@njmu.edu.cn.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32641052

Citation

Mao, Xinyu, et al. "A Comparison Between Pylorus-preserving and Distal Gastrectomy in Surgical Safety and Functional Benefit With Gastric Cancer: a Systematic Review and Meta-analysis." World Journal of Surgical Oncology, vol. 18, no. 1, 2020, p. 160.
Mao X, Xu X, Zhu H, et al. A comparison between pylorus-preserving and distal gastrectomy in surgical safety and functional benefit with gastric cancer: a systematic review and meta-analysis. World J Surg Oncol. 2020;18(1):160.
Mao, X., Xu, X., Zhu, H., Ji, C., Lu, X., & Wang, B. (2020). A comparison between pylorus-preserving and distal gastrectomy in surgical safety and functional benefit with gastric cancer: a systematic review and meta-analysis. World Journal of Surgical Oncology, 18(1), 160. https://doi.org/10.1186/s12957-020-01910-y
Mao X, et al. A Comparison Between Pylorus-preserving and Distal Gastrectomy in Surgical Safety and Functional Benefit With Gastric Cancer: a Systematic Review and Meta-analysis. World J Surg Oncol. 2020 Jul 8;18(1):160. PubMed PMID: 32641052.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A comparison between pylorus-preserving and distal gastrectomy in surgical safety and functional benefit with gastric cancer: a systematic review and meta-analysis. AU - Mao,Xinyu, AU - Xu,Xinlei, AU - Zhu,Hua, AU - Ji,Chunpeng, AU - Lu,Xu, AU - Wang,Baolin, Y1 - 2020/07/08/ PY - 2020/04/14/received PY - 2020/06/10/accepted PY - 2020/7/10/entrez PY - 2020/7/10/pubmed PY - 2020/7/10/medline KW - Distal gastrectomy KW - Early gastric cancer KW - Meta-analysis KW - Pylorus-preserving gastrectomy SP - 160 EP - 160 JF - World journal of surgical oncology JO - World J Surg Oncol VL - 18 IS - 1 N2 - BACKGROUND: Due to better functional outcomes, pylorus-preserving gastrectomy (PPG) has been widely applied for early gastric cancer (EGC) patients as an alternative to distal gastrectomy (DG). However, controversies still persist regarding the surgical efficacy and oncological safety of PPG. METHODS: Original studies comparing PPG and DG for EGC were searched in PubMed, Embase, and the Cochrane Register of Controlled Trials up to December 2019. The weight mean difference, standardized mean difference, or odds risk was used to calculate the short-term and long-term outcomes between the two groups. RESULTS: Twenty-one comparative studies comprising 4871 patients (1955 in the PPG group and 2916 in the DG group) were enrolled in this systematic review and meta-analysis. PPG showed longer hospital day, decreased harvested lymph nodes, and more delayed gastric emptying. However, PPG had the benefits of lower incidence of anastomosis leakage, early dumping syndrome, gastritis and bile reflux, and better recovery of total protein, albumin, hemoglobin, and weight. No difference was found in operative time, blood loss, and overall complications. Moreover, the long-term survival and recurrence rate were similar in two groups. CONCLUSION: Owing to the non-inferiority of surgery and oncology outcomes and the superiority of function outcomes in PPG, we revealed that PPG can be clinically applicable instead of DG in EGC. However, more high-quality comparative studies and randomized clinical trials would be required for further confirmation. SN - 1477-7819 UR - https://www.unboundmedicine.com/medline/citation/32641052/A_comparison_between_pylorus-preserving_and_distal_gastrectomy_in_surgical_safety_and_functional_benefit_with_gastric_cancer:_a_systematic_review_and_meta-analysis L2 - https://wjso.biomedcentral.com/articles/10.1186/s12957-020-01910-y DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.