Proximal gastrectomy versus total gastrectomy for adenocarcinoma of esophagogastric junction: a meta-analysis / 中华胃肠外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To compare the efficacy of proximal gastrectomy(PG) and total gastrectomy(TG) for adenocarcinoma of esophagogastric junction.</p><p><b>METHODS</b>Clinical trials comparing PG with TG for adenocarcinoma of esophagogastric junction published from 1990 to 2012 were searched in Cochrane library, Medline, Embase and China National Knowledge Infrastructure (CNKI), Wanfang Data. Review manager 5.0 was used for meta-analysis and outcome measures included mortality and complication morbidity, as well as nutritional state.</p><p><b>RESULTS</b>A total of 10 studies including 2481 patients were identified and analyzed. The results showed no significant differences in the mortality(OR=1.00, P=0.99) and complication morbidity(OR=2.14, P=0.12) between PG and TG. However, anastomotic stenosis(OR=5.40, P<0.01) and reflux esophagitis(OR=7.12, P=0.01) were more frequently observed in PG group. The nutritional state in TG group was comparable with PG group(WMD=2.09, P=0.57).</p><p><b>CONCLUSION</b>TG is superior to PG in reducing the morbidity of anastomotic stenosis and reflux esophagitis.</p>