Pathological and oncological outcomes of pylorus-preserving versus conventional distal gastrectomy in early gastric cancer: a systematic review and meta-analysis

医学 荟萃分析 优势比 胃切除术 淋巴结切除术 外科肿瘤学 置信区间 内科学 幽门 科克伦图书馆 病态的 切除缘 癌症 胃肠病学 普通外科 外科 切除术
作者
Sen Hou,Fan Liu,Zhidong Gao,Yingjiang Ye
出处
期刊:World Journal of Surgical Oncology [BioMed Central]
卷期号:20 (1) 被引量:3
标识
DOI:10.1186/s12957-022-02766-0
摘要

Abstract Background Pylorus-preserving gastrectomy (PPG) is a function-preserving surgery for the treatment of early gastric cancer (EGC) in the middle third of the stomach. According to the literature reports, PPG decreases the incidence of dumping syndrome, bile reflux, gallstone formation, and nutritional deficit compared with conventional distal gastrectomy (CDG). However, the debates about PPG have been dominated by the incomplete lymphadenectomy and oncological safety. We carried out a systematic review and meta-analysis to evaluate the pathological and oncological outcomes of PPG. Methods The protocol was registered in PROSPERO under number CRD42022304677. Databases including PubMed, Embase, Web of Science, and the Cochrane Register of Controlled Trials were searched before February 21, 2022. The outcomes included the pooled odds ratios (ORs) for dichotomous variables and weighted mean differences (WMDs) for continuous variables. For all outcomes, 95% confidence intervals (CIs) were calculated. Meta-analysis was performed using STATA software (Stata 14, Stata Corporation, Texas) and Review Manager 5.4. Results A total of 4500 patients from 16 studies were included. Compared with the CDG group, the PPG group had fewer lymph nodes harvested (WMD= −3.09; 95% CI −4.75 to −1.43; P < 0.001). Differences in the number of resected lymph nodes were observed at stations No. 5, No. 6, No. 9, and No. 11p. There were no differences in lymph node metastasis at each station. Shorter proximal resection margins (WMD = −0.554; 95% CI −0.999 to −0.108; P = 0.015) and distal resection margins (WMD = −1.569; 95% CI −3.132 to −0.007; P = 0.049) were observed in the PPG group. There were no significant differences in pathological T1a stage (OR = 0.99; 95% CI 0.80 to 1.23; P = 0.88), T1b stage (OR = 1.01; 95% CI 0.81 to 1.26; P = 0.88), N0 stage (OR = 0.97; 95% CI 0.63 to 1.48; P = 0.88), tumor size (WMD = −0.10; 95% CI −0.25 to 0.05; P = 0.187), differentiated carcinoma (OR = 1.04; 95% CI 0.74 to 1.47; P = 0.812) or signet ring cell carcinoma (OR = 1.22; 95% CI 0.90 to 1.64; P = 0.198). No significant differences were observed between the groups in terms of overall survival (HR = 0.63; 95% CI 0.24 to 1.67; P = 0.852) or recurrence-free survival (HR = 0.29; 95% CI 0.03 to 2.67; P = 0.900). Conclusions The meta-analysis of existing evidence demonstrated that the survival outcomes of PPG may be comparable to those of CDG. However, fewer lymph nodes at stations in No. 5, No. 6, No. 9, and No. 11p were harvested with PPG. We also found shorter proximal resection margins and distal resection margins for PPG, meaning more remnant stomachs would be preserved in PPG.

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
suger完成签到,获得积分10
刚刚
科研2121发布了新的文献求助10
1秒前
Stardust发布了新的文献求助10
1秒前
浮浮世世完成签到,获得积分10
1秒前
2秒前
完美世界应助非一采纳,获得10
2秒前
果果完成签到,获得积分10
6秒前
万能图书馆应助好滴捏采纳,获得10
6秒前
6秒前
6秒前
科目三应助拼搏一曲采纳,获得10
6秒前
量子星尘发布了新的文献求助10
8秒前
9秒前
852应助lemonkane采纳,获得20
9秒前
思源应助linn采纳,获得10
10秒前
lilila666发布了新的文献求助10
10秒前
13秒前
张钦奎发布了新的文献求助10
13秒前
Jem完成签到,获得积分10
13秒前
悦悦应助天真的冬瓜采纳,获得10
14秒前
猪猪侠完成签到,获得积分10
16秒前
17秒前
zyj完成签到,获得积分10
18秒前
18秒前
啦啦啦发布了新的文献求助10
19秒前
20秒前
20秒前
天真的冬瓜完成签到,获得积分10
21秒前
23秒前
24秒前
啦啦啦完成签到,获得积分10
24秒前
CodeCraft应助一方通行采纳,获得10
24秒前
Stardust发布了新的文献求助10
24秒前
传奇3应助summer采纳,获得30
25秒前
机灵的忆梅完成签到 ,获得积分10
26秒前
上官若男应助科研2121采纳,获得10
27秒前
寒冰寒冰完成签到,获得积分10
28秒前
张怡博发布了新的文献求助10
28秒前
我是老大应助Nature_Science采纳,获得10
30秒前
30秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
‘Unruly’ Children: Historical Fieldnotes and Learning Morality in a Taiwan Village (New Departures in Anthropology) 400
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3989378
求助须知:如何正确求助?哪些是违规求助? 3531442
关于积分的说明 11254002
捐赠科研通 3270126
什么是DOI,文献DOI怎么找? 1804887
邀请新用户注册赠送积分活动 882087
科研通“疑难数据库(出版商)”最低求助积分说明 809173