Abstract:
INTRODUCTION:The extent of optimal gastric resection for proximal gastric cancer (PGC) continues to remain controversial, and a final consensus is yet to be met. The current study aimed to compare the perioperative outcomes, postoperative complications, and overall survival (OS) of proximal gastrectomy (PG) versus total gastrectomy (TG) in the treatment of PGC through a meta-analysis. METHODS:We systematically searched PubMed, Embase, The Cochrane Library, and Web of Science for articles published in English since database establishment to October 2019. Evaluated endpoints were perioperative outcomes, postoperative complications, and long-term survival outcomes. RESULTS:A total of 2,896 patients in 25 full-text articles were included, of which one was a prospective randomized study, one was a clinical phase III trial, and the rest were retrospective comparative studies. The PG group showed a higher incidence of anastomotic stenosis (OR = 2.21 [95% CI: 1.08-4.50]; p = 0.03) and reflux symptoms (OR = 3.33 [95% CI: 1.85-5.99]; p < 0.001) when compared with the TG group, while no difference was found in PG patients with double-tract reconstruction (DTR). The retrieved lymph nodes were clearly more in the TG group (WMD = -10.46 [95% CI: -12.76 to -8.17]; p < 0.001). The PG group was associated with a better 5-year OS relative to TG with 11 included studies (OR = 1.35 [95% CI: 1.03-1.77]; p = 0.03). After stratification for early gastric cancer and PG with DTR groups, however, there was no significant difference between the 2 groups (OR = 1.35 [95% CI: 0.59-2.45]; p = 0.62). CONCLUSION:In conclusion, PG was associated with a visible improved long-term survival outcome for all irrespective of tumor stage, while a similar 5-year OS for only early gastric cancer patients between the 2 groups. Future randomized clinical trials of esophagojejunostomy techniques, such as DTR following PG, are expected to prevent postoperative complications and assist surgeons in the choice of surgical approach for PGC patients.
journal_name
Dig Surgjournal_title
Digestive surgeryauthors
Zhao L,Ling R,Chen J,Shi A,Chai C,Ma F,Zhao D,Chen Ydoi
10.1159/000506104subject
Has Abstractpub_date
2021-01-01 00:00:00pages
1-13issue
1eissn
0253-4886issn
1421-9883pii
000506104journal_volume
38pub_type
杂志文章,评审abstract:BACKGROUND:Biliary leakage after liver resection continues to be reported. Management of bile leakage has changed in recent years, with nowadays non-surgical procedures as the preferred treatment. METHODS:Biliary leakage and management were assessed in 381 patients who underwent liver resection between January 2005 an...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000335734
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND/AIM:Delay of laparoscopic cholecystectomy after the diagnosis of biliary colic may increase the probability of recurrent emergency admission while awaiting elective cholecystectomy. The aim of this study was to compare the possible advantages and safety of urgent laparoscopic cholecystectomy (ULC) with elect...
journal_title:Digestive surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1159/000085300
更新日期:2005-01-01 00:00:00
abstract::The abdominal cocoon is a rare disease that is characterized by a total or partial encasement of the small bowel by a thick and fibrotic membrane. Thirty-five cases were reported since it was first described. It occurs primarily in females. Preoperative diagnosis is a matter of challenge and usually made at laparotomy...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000065827
更新日期:2002-01-01 00:00:00
abstract::Tumour recurrence that obstructs the afferent limb, blocking outflow of bile and pancreatic juice, constitutes a major clinical problem after a Whipple procedure. The endoscopic route is often not a possible alternative. Surgery may be difficult and perhaps dangerous to the often very sick patient and decompression wi...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000071760
更新日期:2003-01-01 00:00:00
abstract::Laparoscopic gastrectomy for gastric cancer is rapidly becoming popular because of the technical developments and the accumulated data of laparoscopic surgery in gastric cancer patients. The aim of this review is to present the current body of evidence and to highlight controversial issues of laparoscopic gastrectomy ...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000350884
更新日期:2013-01-01 00:00:00
abstract::Ectopic pancreas is an uncommon condition and is usually found in the gastrointestinal tract, such as stomach, duodenum and jejunum. However, ectopic pancreas in the ampulla of Vater is rare and its clinical presentations may be similar to periampullary cancer. It is difficult to diagnose preoperatively. We present su...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000096158
更新日期:2006-01-01 00:00:00
abstract::The intestinal barrier function is considered to play an important role in protecting the penetration of luminal antigens, associated with the development of secondary infection and sepsis and the initiation of the multiple organ dysfunction syndrome. The intestinal mucosal barrier against luminal macromolecules and m...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018651
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine the early postoperative hematological changes after spleen-preserving distal pancreatectomy (SpDP) with preservation of the splenic artery and vein (PSAV). METHODS:We reviewed 53 patients who underwent SpDP with PSAV (n = 21) or distal pancreatectomy with splenectomy (...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000337312
更新日期:2012-01-01 00:00:00
abstract::Anastomotic leakage after colorectal surgery is correlated with considerable morbidity and mortality. Although many studies focus on risk factors and detection, studies on the treatment strategy for colorectal anastomotic leakage are scarce. A national questionnaire amongst 350 members of the Dutch Society for Gastroi...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000346348
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND/AIMS:Primary distal bile duct adenocarcinomas (DBDAs) are unusual neoplasms, necessitating pancreaticoduodenectomy for cure. The aims of this study were to evaluate the prognostic importance of lymphatic and perineural invasion, long-term outcome of patients after resection, and differences in outcome with h...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018798
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND/AIM:Laparoscopy-assisted surgery has proved useful in the treatment of early gastric cancer, but its use in advanced cancer has rarely been studied. To investigate the efficacy and advantages of laparoscopy-assisted distal gastrectomy (LADG) with D2 dissection of lymph nodes versus conventional open D2 dista...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000281818
更新日期:2010-01-01 00:00:00
abstract::The introduction and widespread application of minimally invasive surgery has been one of the most important innovations that radically changed the practice of surgery during the last few decades. The application to pancreatic surgery of minimally invasive approach has only recently emerged: both laparoscopic distal p...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000445012
更新日期:2016-01-01 00:00:00
abstract:INTRODUCTION:To elucidate the clinical presentation, diagnosis and management of primary hepatic carcinoid tumours, a literature search was conducted and summarized. MATERIALS AND METHODS:Published primary hepatic carcinoid tumour case reports and series were searched and selected in the Medline, EMBASE and Cochrane L...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000167021
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND/AIMS:Intratumoral hemodynamics or tumor perfusion is useful in understanding the pathological background of the cancer. A parameter for a non-invasive, preoperative assessment of tumor perfusion has yet to be developed. METHODS:The study included 50 patients who underwent surgery for gastric cancer. Perfusi...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000288703
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Cholecystolithiasis is a common disease. Cholecystectomy is the main treatment method but is associated with various complications in some patients. This study explores a novel, minimally invasive surgery for the removal of calculi and the preservation of the gallbladder using a laparoscope combined with the...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000357823
更新日期:2013-01-01 00:00:00
abstract::We describe a case of splenic abscess following lithotripsy of pancreatic stones, for which emergency splenectomy eventually had to be performed. It is important to be aware of this complication, because splenic abscess is still a life-threatening entity. ...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000050140
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Laparoscopic sigmoidectomy for diverticulitis has initially been confined to the elective setting. However, open acute sigmoidectomy for perforated diverticulitis is associated with high morbidity rates that might be reduced after laparoscopic surgery. The aim of this systematic review was to assess the feas...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000441150
更新日期:2016-01-01 00:00:00
abstract::Resection of liver metastases for locally resectable pancreatic cancer has rarely been performed. Recently, promising results regarding morbidity and mortality as well as long-term survival have been shown. Thus, we conducted a systematic review of the literature on pancreatic cancer resection with associated liver me...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000184739
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Chyle leaks are a rare complication following abdominal surgery. The aim of this study is to describe the management of chyle leaks following surgery for pancreatico-duodenal malignancy. METHODS:Data were collated from a consecutive series of 105 patients who had undergone a pancreatico-duodenectomy for mal...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000108324
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:External drainage is the traditional surgical therapy for infected pancreatic pseudocyst, although associated with high morbidity and mortality rates. In this study it was determined whether internal drainage is feasible with acceptable postoperative morbidity and recurrence rates. METHODS:A retrospective c...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018776
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND/AIMS:Widespread clinical application of islet transplantation remains restricted, because of insufficient methods to prevent rejection and autoimmune destruction of islet grafts. In this study we demonstrate long-term function of islets of Langerhans within a capsule of porcine chondrocytes which may serve a...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000050130
更新日期:2001-01-01 00:00:00
abstract::Ileal J-pouch-anal anastomosis is a commonly accepted surgical treatment for patients with ulcerative colitis. However, making a J-pouch anal anastomosis can be difficult due to anatomical variations of patients. We experienced an informative case of ulcerative colitis in which the ileal pouch was damaged when it was ...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000105526
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND/AIMS:Oesophageal intubation remains one of the principal methods of palliation for an obstructing oesophageal carcinoma. We present a case which illustrates a rare but fatal complication of this procedure. METHODS:A 60-year-old female with oesophageal cancer presented with total dysphagia 9 months following...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018886
更新日期:2000-01-01 00:00:00
abstract:AIMS:To evaluate the role of the Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM), the Portsmouth variant (p-POSSUM) and the Glasgow Prognostic Score (GPS) in predicting outcome after pancreatic surgery with reference to the International Study Group of Pancreatic Surge...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000313693
更新日期:2010-01-01 00:00:00
abstract::One of the possible long-term complications following an ileoanal pouch procedure is the development of malignancy in the mucosa of the rectal stump. Only 10 such cases have been reported so far. We report the case of a 23-year-old male who had ulcerative colitis with high-grade dysplasia and underwent an ileoanal pou...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000068855
更新日期:2003-01-01 00:00:00
abstract::As well as the pronounced effect on body mass index (BMI), bariatric surgery is increasingly recognized as being associated with improvements in morbidity and mortality in a range of conditions, from airways disease to cancer. In metabolic disease, the impact of bariatric surgery is particularly obvious with marked im...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000351440
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND/AIMS:Because the TNM system disregards the number of lymph nodes dissected and inter-individual differences exist in the number of regional lymph nodes, the lymph node ratio (LNR), which is estimated by dividing the number of metastatic lymph nodes by the number of dissected lymph nodes, has been proposed as...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000355444
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Although evidence is growing that most patients who need an operation for diverticular disease of the sigmoid colon can be treated by a single-stage procedure, a two-stage procedure will still be necessary in some patients because of significant sepsis or technical difficulties. The outcomes of 65 patients w...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000091444
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:In order to diagnose an unsuspected gallbladder carcinoma and to examine whether a differential diagnosis could be made between cancer and noncancerous lesions during surgery, we evaluated the findings of fine structures of various types of gallbladder mucosa. METHODS:We used stereomicroscopy with a dye-con...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000050156
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND/AIMS:Although the diagnostic value of fluorine-18 2-fluoro-2-deoxy-D-glucose (F-18-FDG) positron emission tomography/computed tomography (F-18-FDG-PET/CT) in patients with colorectal cancer (CRC) has been reported, the association between the F-18-FDG uptake in metastatic lymph nodes (FDGLN) and clinicopatho...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000448222
更新日期:2017-01-01 00:00:00