RESUMO
El tipo de gastrectomía, total (GT) o distal (GD), en el cáncer gástrico medio o distal no está claramente consensuada, sobre todo cuando es indiferenciado o difuso de Lauren. Pretendemos en este metaanálisis definir en términos de supervivencia y morbimortalidad cuál de las 2 técnicas debiera ser recomendada. Se han incluido trabajos prospectivos y retrospectivos que comparen ambas técnicas hasta un total de 6.303 pacientes (3.641 GD y 2.662 GT). La GD se asoció de forma significativa con menos complicaciones, menos fístulas anastomóticas y menos mortalidad peroperatoria. El número de ganglios en la GD fue significativamente menor, pero siempre por encima de 15. Por último, la supervivencia a 5 años de la GD fue también superior. Por tanto, la GD, siempre que se obtenga un margen de seguridad e independientemente del tipo histológico, debe efectuarse en la cirugía de cáncer distal de estómago
There is no clear agreement on the type of gastrectomy to be used (either total [TG] or distal [DG]) in middle or distal gastric cancer, especially when it is undifferentiated or Lauren diffuse type. In this meta-analysis, we intend to define which of the 2 techniques should be recommended, based on survival, morbidity and mortality rates. Prospective and retrospective studies comparing both techniques have been included for a total of 6303 patients (3,641 DG and 2,662 TG). DG was significantly associated with fewer complications, fewer anastomotic fistulae, and less perioperative mortality. The number of lymph nodes in DG was significantly lower, but always above 15. Finally, even the 5-year survival of DG was also higher. Therefore, DG, as long as a safety margin is obtained and regardless of the histological type, should be performed in surgery for distal stomach cancer
Assuntos
Humanos , Neoplasias Gástricas/cirurgia , Adenocarcinoma/cirurgia , Gastrectomia/métodos , Gastrectomia/mortalidade , Adenocarcinoma/mortalidade , Neoplasias Gástricas/mortalidade , Fatores de Tempo , Resultado do Tratamento , Análise de SobrevidaRESUMO
There is no clear agreement on the type of gastrectomy to be used (either total [TG] or distal [DG]) in middle or distal gastric cancer, especially when it is undifferentiated or Lauren diffuse type. In this meta-analysis, we intend to define which of the 2techniques should be recommended, based on survival, morbidity and mortality rates. Prospective and retrospective studies comparing both techniques have been included for a total of 6303 patients (3,641 DG and 2,662 TG). DG was significantly associated with fewer complications, fewer anastomotic fistulae, and less perioperative mortality. The number of lymph nodes in DG was significantly lower, but always above 15. Finally, even the 5-year survival of DG was also higher. Therefore, DG, as long as a safety margin is obtained and regardless of the histological type, should be performed in surgery for distal stomach cancer.
