Effect of endoscopic resection on short-term surgical outcomes of subsequent laparoscopic gastrectomy: a meta-analysis

Abstract

Background Endoscopic resection (ER) might affect subsequent laparoscopic gastrectomy (LG) because of the electrical coagulation, but the effect remains controversial. The purpose of this meta-analysis was to analyze the effect of ER on the short-term surgical outcomes of subsequent LG. Materials and methods The PubMed, EMBASE, and Cochrane Library databases were searched to find eligible studies published from inception to March 21, 2021. Short-term surgical outcomes were compared between the ER-LG group and the LG-only group. The registration ID of this current meta-analysis on PROSPERO is CRD42021238031. Results Nine studies involving 3611 patients were included in this meta-analysis. The LG-only group had a higher T stage (T1-T2: OR=2.42, 95% CI=1.09 to 5.34, P=0.03; T3-T4: OR=0.41, 95% CI=0.19 to 0.91, P=0.03) than the ER-LG group. The ER-LG group showed a shorter operation time than the LG-only group (MD=−5.98, 95% CI=−10.99 to −0.97, P=0.02). However, no difference was found in operation time after subgroup analysis of propensity score matching studies. No significant difference was found in intraoperative blood loss, time to first oral feeding, or postoperative hospital stay between the ER-LG group and the LG-only group. And no significance was found in overall complications (OR=1.16, 95% CI=0.89 to 1.50, P=0.27), complications of grade ≥ II (OR=1.11, 95% CI=0.71 to 1.73, P=0.64), complications of grade ≥ III b (OR=1.47, 95% CI=0.49 to 4.43, P=0.49) between the ER-LG group and the LG-only group. Conclusions ER did not affect subsequent LG in terms of short-term outcomes, and the ER-LG group might have a shorter operation time than the LG-only group.

Does Extended Intraoperative Peritoneal Lavage Really Bring Benefit on Patients With Gastric Cancer? A Meta-Analysis of Published Clinical Trials

“…Gastric cancer is the fifth most common cancer in the world and the third leading cause of cancer-related deaths, especially in East Asia (1), and gastrectomy is still the main treatment for gastric cancer (2)(3)(4). Peritoneal metastasis (PM) is the main method of distant metastasis in gastric cancer and the main cause of cancerrelated mortality.…”

Red blood cell distribution width has a prognostic value for gastric cancer patients after gastrectomy: A pooling-up analysis

“…[32] Prognostic indicators were needed identifying to improve the survival. [33,34] Meanwhile, some articles investigated that several cancers were caused by inflammatory responses, and then lead to malnutrition. [35–38] Therefore, some inflammation parameters including platelet distribution width, [24] neutrophil to lymphocyte ratio, [39] mean corpuscular volume, [14] RDW [18–25,30,31] and white blood cell count [40] were reported to have close correlations with poor prognosis for GC patients.…”

“…Studies Participants (high RDW/low RDW) Odds ratio/mean difference (95% CI) Heterogeneity Age ≥60 2 [25,31] 167/164 2.58 [1.08, 6.13]; P = .03 I 2 = 70%; P = .07 <60 2 167/164 0.39 [0.16, 0.92]; P = .03 I 2 = 70%; P = .07 Gender Male 4 [19,21,25,30] 345/742 1.0 [0.64, 1.56]; P = .99 I 2 = 52%; P = .10 female 4 345/742 0.93 [0.70, 1.24]; P = .62 I 2 = 52%; P = .10 Tumor diameter ≤4 3 [19,21,31] 316/460 0.51 [0.35, 0.75]; P = .0006 I 2 = 28%; P = .25 >4 3 316/450 1.95 [1.33, 2.85]; P = .0006 I 2 = 28%; P = .25 T stage T1,2 4 [19,21,25,31] 400/742 0.52 [0.29, 0.94]; P = .03 I 2 = 70%; P = .02 T3,4 4 400/742 1.91 [1.07, 3.42]; P = .03 I 2 = 70%; P = .02 N stage N0 4 [19,21,25,31] 400/742 0.62 [0.39, 0.99]; P = .05 I 2 = 62%; P = .05 N1, N2, N3 [19,21] 233/578 1.36 [0.93, 1.98]; P = .11 I 2 = 0%; P = .64 Vascular invasion 2 [19,31] 211/406 0.72 [0. indicators were needed identifying to improve the survival. [33,34] Meanwhile, some articles investigated that several cancers were caused by inflammatory responses, and then lead to malnutrition. [35][36][37][38] Therefore, some inflammation parameters including platelet distribution width, [24] neutrophil to lymphocyte ratio, [39] mean corpuscular volume, [14] RDW [18][19][20][21][22][23][24][25]30,…”

Analysis of risk factors for the sigmoid stoma complications in patients after abdominoperineal resection surgery: An observational study

“…[1][2][3] The treatment of CRC still relies on surgery-based comprehensive treatment. [4][5][6][7][8][9][10] When RC is close to the anus, most patients have to undergo abdominoperineal resection (APR) surgery with a sigmoid colostomy. [11][12][13][14] Although advances in surgical techniques have allowed more opportunities for anal preservation in patients with LRC, postoperative dysfunction and higher recurrence rates make the patient's quality of life (QoL) much worse than that of patients with a stoma.…”