Laparoscopic versus Open Approach for Siewert Type II/III Adenocarcinoma of the Esophagogastric Junction: A Systematic Review and Meta-Analysis.

IF 1.8 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Digestive Surgery Pub Date : 2022-01-01 DOI:10.1159/000528912

Ming Wu, Wei Zhang, Yan-Yang Song

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引用次数: 1

Abstract

Introduction: Due to the specific location, the potential advantages of laparoscopic gastrectomy (LG) compared with open gastrectomy (OG) for Siewert II/III adenocarcinoma of the esophagogastric junction (AEG) remain uncertain. The current study aimed to compare the short- and long-term outcomes of LG versus OG in treating Siewert type II/III adenocarcinoma.

Methods: We searched PubMed, Embase, Web of Science, MEDLINE (hosted by Ovid), and the Cochrane Library for publications till July 2022 and then used the RevMan 5.3 software for statistical analysis.

Results: Ten publications from 10 medical centers were included, with 1,516 cases from the LG group and 1,219 from the OG group. Meta-analysis results showed that the LG group was superior to the OG group in intraoperative blood loss, hospital stay, lymph nodes retrieved, time to ambulation, time to first flatus, time to diet, 5-year overall survival, and 5-year disease-free survival. There was no significant difference between the two groups in operative time, overall complications, proximal margin, distal margin, pulmonary infection, anastomotic leakage, mortality, ileus, or absolute infection.

Conclusions: Compared with OG, LG is associated with better surgical and long-term outcomes in Siewert type II/III AEG. LG is a safe and feasible option for treating Siewert type II/III AEG. However, studies with large sample sizes, long follow-up periods, and rigorous designs are needed for verification.

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腹腔镜与开放入路治疗食管胃交界处Siewert II/III型腺癌:一项系统综述和meta分析

导言:由于位置的特殊性，对于食管胃交界处siwert II/III型腺癌(AEG)，腹腔镜胃切除术(LG)与开放式胃切除术(OG)相比的潜在优势尚不确定。目前的研究旨在比较LG和OG治疗siwert II/III型腺癌的短期和长期结果。方法:检索PubMed、Embase、Web of Science、MEDLINE(由Ovid托管)和Cochrane Library，检索截止到2022年7月的出版物，使用RevMan 5.3软件进行统计分析。结果:纳入来自10个医疗中心的10篇出版物，其中LG组1516例，OG组1219例。荟萃分析结果显示，LG组术中出血量、住院时间、淋巴结清扫、下床时间、首次排气时间、饮食时间、5年总生存期和5年无病生存期均优于OG组。两组在手术时间、总并发症、近缘、远缘、肺部感染、吻合口漏、死亡率、肠梗阻、绝对感染等方面无显著差异。结论:与OG相比，LG在Siewert II/III型AEG中具有更好的手术和长期预后。LG是治疗Siewert II/III型AEG的一种安全可行的选择。然而，研究样本量大，随访时间长，设计严谨，需要验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Digestive Surgery 医学-外科

CiteScore

4.90

自引率

3.70%

发文量

审稿时长

3 months

期刊介绍： ''Digestive Surgery'' presents a comprehensive overview in the field of gastrointestinal surgery. Interdisciplinary in scope, the journal keeps the specialist aware of advances in all fields that contribute to improvements in the diagnosis and treatment of gastrointestinal disease. Particular emphasis is given to articles that evaluate not only recent clinical developments, especially clinical trials and technical innovations such as new endoscopic and laparoscopic procedures, but also relevant translational research. Each contribution is carefully aligned with the need of the digestive surgeon. Thus, the journal is an important component of the continuing medical education of surgeons who want their practice to benefit from a familiarity with new knowledge in all its dimensions.