Techniques for reconstruction after distal gastrectomy for cancer: updated network meta-analysis of randomized controlled trials

Lombardo, Francesca; Aiolfi, Alberto; Cavalli, Marta; Mini, Emanuele; Lastraioli, Caterina; Panizzo, Valerio; Lanzaro, Alessio; Bonitta, Gianluca; Campanelli, G.; Bona, Davide

doi:10.1007/s00423-021-02411-6

Cited by 13 publications

(6 citation statements)

References 46 publications

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“…The incidence of anastomotic leakage was similar between the two groups, consistent with previous findings 28 . No significant difference was found in postoperative complications including anastomotic leakage, ileus, pancreatitis, duodenal stump leakage, intra‐abdominal abscess, or wound issues between the two groups.…”

Section: Discussionsupporting

confidence: 90%

“…The incidence of anastomotic leakage was similar between the two groups, consistent with previous findings. 28 No significant difference was found in postoperative complications including anastomotic leakage, ileus, pancreatitis, duodenal stump leakage, intra-abdominal abscess, or wound issues between the two groups. This may be because of the small difference between the two groups, and another reason to explain this is that postoperative complications such as surgical site infection have been reduced with the development of surgical technique and the using of antimicrobial prophylaxis these years, 29 which make it difficult to observed the difference between the two groups with the small sample size of the included studies.…”

Section: Discussionmentioning

confidence: 79%

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Comparison of Billroth II with Braun and Roux‐en‐Y reconstructions after distal gastrectomy for gastric cancer: A meta‐analysis

Chen

Tang

et al. 2023

MedComm – Oncology

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Roux‐en‐Y (RY) and Billroth II with Braun (BB) reconstruction are two similar methods of reconstruction after distal gastrectomy (DG). Currently, it is unclear which method is superior. This meta‐analysis was performed to compare the safety and efficacy of BB and RY reconstruction after DG for gastric cancer. A literature search of Pubmed, Embase, Web of Science, and Cochrane Library was conducted to identify studies comparing BB with RY after DG for gastric cancer until the end of October 2022. Main outcomes assessed were perioperative outcomes, postoperative complications, functional findings, and nutritional status. Meta‐analyses were performed using RevMan 5.4 software. Finally, eight studies with a total of 910 patients were considered for the meta‐analysis. The meta‐analysis results revealed that operation time, anastomosis time, incidence of total complications, and delayed gastric emptying were reduced, and the incidence of bile reflux was increased in patients undergoing BB compared to RY reconstruction. In conclusion, BB has the advantage of reducing operative time, anastomotic time, intraoperative blood loss, overall postoperative complications, and delayed gastric emptying. RY has the advantage of preventing bile reflux and gastritis after surgery.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 79%

Comparison of Billroth II with Braun and Roux‐en‐Y reconstructions after distal gastrectomy for gastric cancer: A meta‐analysis

Chen

Tang

et al. 2023

MedComm – Oncology

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“…These complications seriously affected postoperative recovery and quality-of-life (QoL) [14]. Currently, uncut Roux-en-Y (URY) is most often applied to LDG [15], and relatively little has been reported in LTG [16]. URY has fewer postoperative complications than RY [17,18].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of totally laparoscopic gastrectomy with Uncut Roux-en-Y for gastric cancer: A dual-center retrospective study

Chen

Zheng

Tan

et al. 2023

Preprint

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Background Uncut Roux-en-Y (URY) effectively alleviates the common complications associated with RY, such as Roux-en-Y stasis syndrome (RSS). However, for gastric cancer (GC) patients, it is still controversial whether URY has an impact on long-term prognosis and whether it has fewer input loop recanalization. Therefore, compare whether URY and RY have differences in prognosis and long-term complications of GC patients undergoing totally laparoscopic gastrectomy (TLG). Methods We analyzed the data of patients who underwent TLG combined with digestive tract reconstruction from dual-center between 2016 and 2022. Only patients undergoing URY and RY were selected for analysis. Progression-free survival (PFS) and overall survival (OS) were estimated. Bias between the groups was reduced by propensity score matching (PSM). The Cox proportional hazard regression model was used to further analyze the influence of URY on prognosis. Results 242 GC patients were enrolled (retrospectively registered: IRB-2023-202). The URY had significantly shorter operation time, liquid food intake time, and hospital stays than the RY (P < 0.001). The URY had fewer long-term and short-term postoperative complications than the RY, especially with regard to RSS, reflux esophagitis, and reflux gastritis. The 3-year, and 5-year OS of the URY group and the RY group before PSM: 87.5% vs. 65.6% (P < 0.001), and 81.4% vs. 61.7% (P = 0.001). PSM and Cox multivariate analysis confirmed that compared to RY, URY can improve the short-term and long-term prognosis of GC patients. Conclusion TLG combined with URY for GC, especially for advanced, older, and poorly differentiated patients, can promote postoperative recovery, and improve long-term prognosis.

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“…These complications seriously affected postoperative recovery and quality of life (QoL) [ 14 ]. Currently, uncut Roux-en-Y (URY) is most often applied to LDG [ 15 ], and relatively little has been reported in LTG [ 16 ]. URY has fewer postoperative complications than RY [ 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of totally laparoscopic gastrectomy with uncut Roux-en-Y for gastric cancer: a dual-center retrospective study

Chen,

Zheng,

Tan

et al. 2023

World J Surg Onc

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Background Uncut Roux-en-Y (URY) effectively alleviates the prevalent complexities connected with RY, such as Roux-en-Y stasis syndrome (RSS). Nevertheless, for gastric cancer (GC) patients, it is still controversial whether URY has an impact on long-term prognosis and whether it has fewer afferent loop recanalization. Therefore, compare whether URY and RY have differences in prognosis and long-term complications of GC patients undergoing totally laparoscopic gastrectomy (TLG). Methods We analyzed the data of patients who underwent TLG combined with digestive tract reconstruction from dual-center between 2016 and 2022. Only patients undergoing URY and RY were selected for analysis. Relapse-free survival (RFS) and overall survival (OS) were estimated. Bias between the groups was reduced by propensity score matching (PSM). The Cox proportional hazard regression model was used to further analyze the influence of URY on prognosis. Results Two hundred forty two GC patients were enrolled. The URY had significantly shorter operation time, liquid food intake time, and in-hospital stays than the RY (P < 0.001). The URY had fewer long-term and short-term postoperative complications than the RY, especially with regard to RSS, reflux esophagitis, and reflux gastritis. The 3-year and 5-year OS of the URY group and the RY group before PSM: 87.5% vs. 65.6% (P < 0.001) and 81.4% vs. 61.7% (P = 0.001). PSM and Cox multivariate analysis confirmed that compared to RY, URY can improve the short-term and long-term prognosis of GC patients. Conclusion TLG combined with URY for GC, especially for advanced, older, and poorly differentiated patients, may promote postoperative recovery and improve long-term prognosis.

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Techniques for reconstruction after distal gastrectomy for cancer: updated network meta-analysis of randomized controlled trials

Cited by 13 publications

References 46 publications

Comparison of Billroth II with Braun and Roux‐en‐Y reconstructions after distal gastrectomy for gastric cancer: A meta‐analysis

Comparison of Billroth II with Braun and Roux‐en‐Y reconstructions after distal gastrectomy for gastric cancer: A meta‐analysis

Efficacy and safety of totally laparoscopic gastrectomy with Uncut Roux-en-Y for gastric cancer: A dual-center retrospective study

Efficacy and safety of totally laparoscopic gastrectomy with uncut Roux-en-Y for gastric cancer: a dual-center retrospective study

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