Meta-analysis of the safety and efficacy assessment for the jejunostomy tube placement during the radical resection for gastric carcinoma / 国际外科学杂志

ABSTRACT

Objective:To investigate the safety and efficacy of indignant jejunostomy tube in radical resection of gastric carcinoma.Methods:Using "radical gastrectomy, esophagectomy, jejunostomy, enteral nutrition" as the Chinese search terms and "gastrectomy, esophagectomy, jejunostomy, jejunostomies, enteral nutrition" as the English search terms searched Pubmed, MEDLINE, EMbase, Web of Science, Cochrane Library, CNKI, VIP, Wanfang and CBMdisc. The Chinese and English literatures published at home and abroad on indwelling and non-indwelling jejunostomy tubes after radical resection of gastric carcinoma from January 2010 to December 2020 were collected, including randomized controlled trial and cohort studies. The main outcome measure was the length of hospital stay; the secondary outcome measure was the overall postoperative complication rate, postoperative pulmonary infection rate, intestinal obstruction rate, and body weight changes at 3 and 6 months after radical gastrectomy. Meta-analysis was conducted using RevMan 5.2 software.Results:Finally, 12 articles with a total of 2 173 patients were included. Compared with the non-indwelling jejunostomy tube group, the patients in the indwelling group had a longer hospital stay ( WMD=2.05, P=0.01) and a higher incidence of intestinal obstruction ( OR=11.67, P<0.001). The incidence of overall postoperative complications ( OR=1.24, P=0.31), the incidence of postoperative pulmonary infection ( OR=1.43, P=0.13) and 3 months after radical gastrectomy ( WMD=0.58, P=0.24), 6 months ( P>0.05), the difference were not statistically significant. Conclusions:Indwelling jejunostomy tube placement after radical gastrectomy of gastric carcinoma did not show more therapeutic advantages, but prolonged the length of hospital stay and the probability of intestinal obstruction. Therefore, selective jejunostomy tube placement rather than routine jejunostomy placement should be required.