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

Mao, Xinyu; Xu, Xinlei; Zhu, Hua; Ji, Chunpeng; Xu, Lu; Wang, Baolin

doi:10.1186/s12957-020-01910-y

Cited by 15 publications

(10 citation statements)

References 50 publications

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“…PPG has several advantages over DG for patients with EGC in the middle third of the stomach, including surgical outcomes and long-term nutritional status [ 27 , 39 , 40 , 51 , 54 , 55 ]. A meta-analysis of 4871 patients in one randomized clinical trial (RCT) and 20 non-RCTs showed that PPG was potentially superior to DG in terms of lower incidence of anastomotic leakage, dumping syndrome, gastritis, and bile reflux, and better recovery of total protein, albumin, hemoglobin, and weight [ 55 ]. As shown in Table 2 , the changes in body weight following PPG and DG were 93.1–97.0% and 90.0–95.0%, respectively.…”

Section: Pylorus-preserving Gastrectomy (Ppg)mentioning

confidence: 99%

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Function-Preserving Gastrectomy for Early Gastric Cancer

Hiramatsu

Kikuchi

Takeuchi

2021

Cancers

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Recently, minimally invasive (endoscopic or laparoscopic) treatment for early gastric cancer (EGC) has been widely accepted. However, a standard gastrectomy with radical lymphadenectomy is generally performed in patients with EGC who have no indications for endoscopic resection, and postgastrectomy dysfunction is one of the problems of standard gastrectomy. Function-preserving gastrectomy, such as proximal gastrectomy and pylorus-preserving gastrectomy, can be considered when attempting to preserve the patient’s quality of life (QOL) postoperatively. In addition, sentinel node navigation surgery for EGC has been applied in clinical practice in several prospective studies on function-preserving personalized minimized gastrectomy. In the near future, the sentinel lymph node concept is expected to form the basis for establishing an ideal, personalized, minimally invasive function-preserving treatment for patients with EGC, which will improve their postoperative QOL without compromising their long-term survival. In this review article, we summarize the current status, surgical techniques, and postoperative outcomes of function-preserving gastrectomy for EGC.

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Section: Pylorus-preserving Gastrectomy (Ppg)mentioning

confidence: 99%

“…As shown in Table 2 , the changes in body weight following PPG and DG were 93.1–97.0% and 90.0–95.0%, respectively. No difference was found between the groups regarding operative time, blood loss, and overall complications [ 55 ].…”

Section: Pylorus-preserving Gastrectomy (Ppg)mentioning

confidence: 99%

Function-Preserving Gastrectomy for Early Gastric Cancer

Hiramatsu

Kikuchi

Takeuchi

2021

Cancers

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“…For patients who have extensive linitis plastica, TG is more frequently performed [26]. Recent reports have indicated that, if R0 can be safely achieved, pylorus-preserving resection for gastric cancer should be considered because no difference in survival was reported compared with more extensive procedures [27,28].…”

Section: Resultsmentioning

confidence: 99%

Surgical Management of Gastric Cancer: A Systematic Review

Mocan

2021

JCM

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Gastric cancer is the fifth most common cancer worldwide, and it is responsible for 7.7% of all cancer deaths. Despite advances in the field of oncology, where radiotherapy, neo and adjuvant chemotherapy may improve the outcome, the only treatment with curative intent is represented by surgery as part of a multimodal therapy. Two concepts may be adopted in appropriate cases, neoadjuvant treatment before gastrectomy (G) or primary surgical resection followed by chemotherapy. Such an approach, combined with early detection and better screening, has led to a decrease in the overall incidence of gastric cancer. Unfortunately, malignant tumors of the stomach are often diagnosed in locally advanced or metastatic stages when the median overall survival remains poor. Surgical care in these cases must be provided by a multidisciplinary team in a high-volume center. Important surgical aspects such as optimum resection margins, surgical technique, and number of harvested lymph nodes are important factors for patient outcomes. The standardization of surgical treatment of gastric cancer in accordance with the patient’s profile is of decisive importance for a better outcome. This review aims to summarize the current standards in the surgical treatment of gastric cancer.

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“…The survival rate of patients with gastric cancer has improved due to early detection and treatment [ 10 , 11 ]. As a result, more patients may develop RGC [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

T stage and venous invasion are crucial prognostic factors for long-term survival of patients with remnant gastric cancer: a cohort study

et al. 2021

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Background The incidence of remnant gastric cancer (RGC) after distal gastrectomy is 1–5%. However, as the survival rate of patients with gastric cancer improves due to early detection and treatment, more patients may develop RGC. There is no consensus on the surgical and postoperative management of RGC, and the clinicopathological characteristics correlated with the long-term outcomes remain unclear. Therefore, we investigated the clinicopathological factors associated with the long-term outcomes of RGC. Methods We included 65 consecutive patients who underwent gastrectomy for RGC from January 2000 to December 2015 at the Osaka Medical and Pharmaceutical University Hospital, Japan. The Kaplan–Meier method was used to create survival curves, and differences in survival were compared between the groups (clinical factors, pathological factors, and surgical factors) using the log-rank test. Multivariate analyses using the Cox proportional hazard model were used to identify factors associated with long-term survival. Results No significant differences were noted in the survival rate based on clinical factors (age, body mass index, diabetes mellitus, hypertension, cardiovascular disease, pulmonary complications, liver disease, diet, history of alcohol drinking, and history of smoking) or the type of remnant gastrectomy. Significant differences were noted in the survival rate based on pathological factors and surgical characteristics (intraoperative blood loss, operation time, and the number of positive lymph nodes). Multivariate analysis revealed that the T stage (hazard ratio, 5.593; 95% confidence interval [CI], 1.183–26.452; p = 0.030) and venous invasion (hazard ratio, 3.351; 95% CI, 1.030–10.903; p = 0.045) were significant independent risk factors for long-term survival in patients who underwent radical resection for RGC. Conclusions T stage and venous invasion are important prognostic factors of long-term survival after remnant gastrectomy for RGC and may be keys to managing and identifying therapeutic strategies for improving prognosis in RGC.

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

Cited by 15 publications

References 50 publications

Function-Preserving Gastrectomy for Early Gastric Cancer

Function-Preserving Gastrectomy for Early Gastric Cancer

Surgical Management of Gastric Cancer: A Systematic Review

T stage and venous invasion are crucial prognostic factors for long-term survival of patients with remnant gastric cancer: a cohort study

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