Author:
Liu Yu-hang,Meng Rui,Zhu Bing,Zhan Qi-qi,Yang Xin,Ding Guan-yi,Jia Chun-liang,Xu Wei-guo
Abstract
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.
Funder
the Natural Science Foundation of Hebei
Key Project of Medical Science Research of Hebei
Project of introducing overseas students of Human Resources and Social Security of Hebei
Project of Beijing, Tianjin, and Hebei Basic Research Cooperation
Publisher
Springer Science and Business Media LLC
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