A meta-analysis of the efficacy of Roux-en-Y anastomosis and jejunal interposition after total gastrectomy
Abstract Background To compare the clinical efficacy of two alimentary tract reconstruction methods—“P”-shape jejunal interposition (PJI) and Roux-en-Y anastomosis after total gastrectomy. Method The following search phrases were utilized to search PubMed, Cochrane Library, Embase, China Academic Jo...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-023-03002-z |
| _version_ | 1797836432545415168 |
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| author | Yu-hang Liu Rui Meng Bing Zhu Qi-qi Zhan Xin Yang Guan-yi Ding Chun-liang Jia Wei-guo Xu |
| author_facet | Yu-hang Liu Rui Meng Bing Zhu Qi-qi Zhan Xin Yang Guan-yi Ding Chun-liang Jia Wei-guo Xu |
| author_sort | Yu-hang Liu |
| collection | DOAJ |
| description | Abstract Background To compare the clinical efficacy of two alimentary tract reconstruction methods—“P”-shape jejunal interposition (PJI) and Roux-en-Y anastomosis after total gastrectomy. Method The following search phrases were utilized to search PubMed, Cochrane Library, Embase, China Academic Journals Network Full-text Database (CNKI), and Wanfang Database as of April 2022: “gastrectomy,” “Roux-en-Y,” “interposition,” “total gastrectomy,” and “jejunal interposition.” Meta-analysis of the operation time, intraoperative blood loss, complication rate, and postoperative nutritional status of patients was performed using RevMan 5.4 software. Results A total of 24 studies and 1887 patients were included in the study. Among patients who received a total gastrectomy, the operation time in the PJI group was substantially longer than that in the Roux-en-Y group (WMD = 19.77, 95% CI: 5.84–33.70, P = 0.005). The incidence of postoperative reflux esophagitis in the PJI group was considerably reduced than that in the Roux-en-Y group (OR = 0.39, 95% CI: 0.28–0.56, P < 0.01). The probability of postoperative dumping syndrome in the PJI group was significantly lower than that in the Roux-en-Y group (OR = 0.27, 95% CI: 0.17–0.43, P < 0.01), and the postoperative body mass changes were significantly lower in the PJI group than in the Roux-en-Y group (WMD = 3.94, 95% CI: 2.24–5.64, P < 0.01). The PJI group had substantially higher postoperative hemoglobin, albumin, and total protein levels than the Roux-en-Y group (WMD = 13.94, 95% CI: 7.77–19.20, P < 0.01; WMD = 3.97, 95% CI: 2.58–5.37, P < 0.01; WMD = 5.31, 95% CI: 3.45–7.16, P < 0.01). The prognostic nutritional index was higher in the PJI group than in the Roux-en-Y group (WMD = 9.25, 95% CI: 7.37–11.13, P < 0.01). Conclusion PJI is a safe and effective reconstruction method and is superior to Roux-en-Y anastomosis in the prevention and treatment of postoperative complications and postoperative nutritional recovery in patients after total gastrectomy. |
| first_indexed | 2024-04-09T15:09:21Z |
| format | Article |
| id | doaj.art-b010694b230042a9a9569225a2839bc8 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-04-09T15:09:21Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-b010694b230042a9a9569225a2839bc82023-04-30T11:18:08ZengBMCWorld Journal of Surgical Oncology1477-78192023-04-0121111110.1186/s12957-023-03002-zA meta-analysis of the efficacy of Roux-en-Y anastomosis and jejunal interposition after total gastrectomyYu-hang Liu0Rui Meng1Bing Zhu2Qi-qi Zhan3Xin Yang4Guan-yi Ding5Chun-liang Jia6Wei-guo Xu7North China University of Science and Technology Affiliated HospitalDepartment of Emergency Intensive Care Unit, Yangpu Hospital, Tongji UniversityTangshan Gongren HospitalNorth China University of Science and Technology Affiliated HospitalNorth China University of Science and Technology Affiliated HospitalTangshan Gongren HospitalTangshan People’s HospitalNorth China University of Science and Technology Affiliated Hospital, Tangshan, 063000, China & Department of Gastrointestinal Surgery, China Hospital Medical Sciences, Shenzhen CenterAbstract Background To compare the clinical efficacy of two alimentary tract reconstruction methods—“P”-shape jejunal interposition (PJI) and Roux-en-Y anastomosis after total gastrectomy. Method The following search phrases were utilized to search PubMed, Cochrane Library, Embase, China Academic Journals Network Full-text Database (CNKI), and Wanfang Database as of April 2022: “gastrectomy,” “Roux-en-Y,” “interposition,” “total gastrectomy,” and “jejunal interposition.” Meta-analysis of the operation time, intraoperative blood loss, complication rate, and postoperative nutritional status of patients was performed using RevMan 5.4 software. Results A total of 24 studies and 1887 patients were included in the study. Among patients who received a total gastrectomy, the operation time in the PJI group was substantially longer than that in the Roux-en-Y group (WMD = 19.77, 95% CI: 5.84–33.70, P = 0.005). The incidence of postoperative reflux esophagitis in the PJI group was considerably reduced than that in the Roux-en-Y group (OR = 0.39, 95% CI: 0.28–0.56, P < 0.01). The probability of postoperative dumping syndrome in the PJI group was significantly lower than that in the Roux-en-Y group (OR = 0.27, 95% CI: 0.17–0.43, P < 0.01), and the postoperative body mass changes were significantly lower in the PJI group than in the Roux-en-Y group (WMD = 3.94, 95% CI: 2.24–5.64, P < 0.01). The PJI group had substantially higher postoperative hemoglobin, albumin, and total protein levels than the Roux-en-Y group (WMD = 13.94, 95% CI: 7.77–19.20, P < 0.01; WMD = 3.97, 95% CI: 2.58–5.37, P < 0.01; WMD = 5.31, 95% CI: 3.45–7.16, P < 0.01). The prognostic nutritional index was higher in the PJI group than in the Roux-en-Y group (WMD = 9.25, 95% CI: 7.37–11.13, P < 0.01). Conclusion PJI is a safe and effective reconstruction method and is superior to Roux-en-Y anastomosis in the prevention and treatment of postoperative complications and postoperative nutritional recovery in patients after total gastrectomy.https://doi.org/10.1186/s12957-023-03002-zAlimentary tract reconstructionJejunal interpositionMeta-analysisRoux-en-YTotal gastrectomy |
| spellingShingle | Yu-hang Liu Rui Meng Bing Zhu Qi-qi Zhan Xin Yang Guan-yi Ding Chun-liang Jia Wei-guo Xu A meta-analysis of the efficacy of Roux-en-Y anastomosis and jejunal interposition after total gastrectomy World Journal of Surgical Oncology Alimentary tract reconstruction Jejunal interposition Meta-analysis Roux-en-Y Total gastrectomy |
| title | A meta-analysis of the efficacy of Roux-en-Y anastomosis and jejunal interposition after total gastrectomy |
| title_full | A meta-analysis of the efficacy of Roux-en-Y anastomosis and jejunal interposition after total gastrectomy |
| title_fullStr | A meta-analysis of the efficacy of Roux-en-Y anastomosis and jejunal interposition after total gastrectomy |
| title_full_unstemmed | A meta-analysis of the efficacy of Roux-en-Y anastomosis and jejunal interposition after total gastrectomy |
| title_short | A meta-analysis of the efficacy of Roux-en-Y anastomosis and jejunal interposition after total gastrectomy |
| title_sort | meta analysis of the efficacy of roux en y anastomosis and jejunal interposition after total gastrectomy |
| topic | Alimentary tract reconstruction Jejunal interposition Meta-analysis Roux-en-Y Total gastrectomy |
| url | https://doi.org/10.1186/s12957-023-03002-z |
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