A Meta-analysis of tubular stomach versus whole stomach for digestive tract reconstruction

doi:10.3969/j.issn.2095-4344.2015.02.029

Abstract

Abstract:

BACKGROUND: Over the past 10 years, scholars have proposed the tubular stomach as an alternative to the whole stomach for digestive tract reconstruction; however, its occurrence rate of postoperative complications has been controversial.
OBJECTIVE: To evaluate the clinical efficacy of tubular stomach versus whole stomach for digestive tract reconstruction in the resection of esophageal carcinoma.
METHODS: The randomized controlled trials about tubular stomach for digestive tract reconstruction in the resection of esophageal carcinoma were searched from PubMed, OVID, CNKI, EBSCO, Science online, Wangfang, Super Star Digital Library, CMB, Baidu and Google search engines. Two searchers screened studies based on the included criteria strictly. Literature quality and bias risk were assessed according to the criteria of Cochrane Collaboration, GRADEprofiler3.6.1 software was used for evaluation of the quality grade, and Revman5.3 for data management and statistical analysis.
RESULTS AND CONCLUSION: Totally 12 randomized controlled trials including 4 137 patients were enrolled. Compared with the whole stomach group, in the tubular stomach group, the incidences of reflux esophagitis and thoracic stomach syndrome were significantly lower, but there was no difference in the incidences of anastomotic leakage and anastomotic stenosis between the two groups. These findings indicate that the tubular stomach as a substitute of the whole stomach for digestive tract reconstruction in the resection of esophageal carcinoma is a safe and effective. However, the literatures included are only in English and Chinese, and there is publication bias and small sample size. Therefore, the large-sample high-quality clinical randomized controlled trials are still needed for further confirmation.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

全文链接：

Key words: Esophageal Neoplasms, Anastomotic Leak, Esophagitis, Peptic

CLC Number:

R318

Liu Lan-bo, Qi Hai, Zheng Shi-yi. A Meta-analysis of tubular stomach versus whole stomach for digestive tract reconstruction[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(2): 316-321.

Figures/Tables 3

References

[1] 车嘉铭,项捷,陈凯,等.管状胃在食管、贲门癌手术中的临床应用[J].中国胸心血管外科临床杂志,2010,17(2):96-98.
[2] Buunnen M, Rooijens PP, Smaal HJ, et al. Vascular anatomy of the stomach related to gastric tube construction. Dis Esophagus.2008;21(3):272-274.
[3] 吴庆琛,管状胃与全胃代食管的食管癌切除术后患者生活质量比较[J].实用医院临床杂志,2011,8(5):3-7.
[4] Collard JM, Tinton N, Malaise J, et al. Esophageal replacement: gastric tube or whole stomach?. Ann Thorac Surg.1995;60(2):261-266.
[5] Shu YS,Sun C,Shi WP,et al. Tubular stomach or whole stomach for esophagectomy through cervico-thoraco- abdominal approach: a comparative clinical study on anastomotic leakage. Ir J Med Sci.2013; 182(3): 477-480.
[6] Zhang M,Wu QC,Li Q, et al. Comparison of the health-related quality of life in patients with narrow gastric tune and whole stomach reconstruction after oncologic esophagectomy: a prospective randomized study. Scand J Surg.2013;102(2): 77-82.
[7] 傅俊惠,黄建豪,吴智勇,等,切除胃小弯的管状胃加颈吻合治疗胸段食管癌前瞻性研究[J].中国基层医药,2008,15(1):18-19.
[8] 冯维中,李泽亚.管状胃重建在食管癌手术中应用的临床研究[J].重庆医学,2011,40(12):1189-1190.
[9] 张建华,黄壮士,付东宏.管状胃在食管癌切除消化道重建术中的应用[J].重庆医学,2012,41(23):2422-2423.
[10] 曹祥,徐绍敢,邓波荣,等,管状胃在食管癌切除消化道重建中的应用[J].临床外科杂志,2013,21(7):530-531.
[11] 李晓明,李学兆,石锋.管胃成形术在食管癌手术中的临床研究[J].中国当代医药,2012,19(20):43-44.
[12] 杨宁,冯永健,薛会岗,等,管状胃重建食管对食管癌术后并发症的预防[J].中华临床医师杂志,2011,05(9):2768-2769.
[13] 潘开云,张文山,黄荣智,等,食管癌切除管状胃与全胃重建食管的对比研究[J].中国肿瘤外科杂志,2012,4(4):236-237.
[14] 郭海周,王建军,周福有,等,管状胃对食管癌切除术后并发症的改善作用[J].中华胃肠外科杂志,2011,14(1):65-66.
[15] 黄国正,李月明,钱晓萍.管状胃在食管癌切除消化道重建术中的应用效果[J].中国当代医药,2014,21(1):62-63.
[16] 程鹏,梁涛,刘波,等.管状胃在食管癌根治术中的应用[J].安徽医药,2013,17(2):225-227.
[17] Feeney C, Reynolds J, Hussey J. Preoperative physical activity levels and postoperative pulmonary complications post esophagectomy. Diseases of the Esophagus. 2011; 24(7): 489-494.
[18] Atkins BZ, Shah AS, Hutcheson KA, et al. Reducing hospital morbidity and mortality following esophagectomy. Ann Thorac Surg.2004;78(4):1170-1176.
[19] Tabatabai A,Hashemi M,Mohajeri G, et al.Incidence and risk factors predisposing anastomotic leak after transhiatal esophagectomy.Ann Thorac Med. 2009;4(4):197-200.
[20] Jo WM, Jae Shin JS, Lee IS. Mid-term outcomes of side-to-side stupled anastomosis in cervical esophagogastrostomy. J Korean Med Sci. 2006;21(6): 1033-1036.
[21] 齐战,朱德成,陈万生,等.胸腔胃对食管癌围手术期呼吸功能的影响[J].中华胸心血管外科杂志,2000,16(3):150-152.
[22] 王宪东,刘大治,赖小刚.食管状胃器械吻合术后吻合口瘘原因分析[J].中华胸心血管外科杂志,2007,23(4):270.
[23] 侯朋远,吴庆琛.食管癌切除术后管状胃与全胃代食管的病人生活质量比较[J].中华胸心血管外科杂志,2010,26(4):260-261.
[24] 董新伟.食管、管状胃测测吻合预防食管癌术后吻合口狭窄和反流的效果[J].中国老年学杂志,2014,34(12):3472-3473.
[25] 季巧金,陈新宝,陈理达.经食管床胃代食管术中缝合纵隔胸膜的疗效观察[J].河南肿瘤学杂志,2002,15(4):277-279.
[26] 张灿斌.管胃成形术在食管重建中的可行性研究[J].河南科技大学学报:医学版,2005,23(3):175-179.
[27] 周天骏,敖翔,李钰泉,等,管状胃在食管癌根治术中的应用及意义[J].中华实验外科杂志,2013,30(5):1057-1059.
[28] Kim HK, Choi YH, Shim JH, et al. Endoscopic evaluation of the quality of the anastomosis after esophagectomy with gastric tube reconstruction. World J Surg. 2008;32(9): 2010-2014.
[29] Heitmiller RF.Impact of gastric tube diameter on upper mediastinal anatomy after transhiatal esophagectomy. Dis Esophagus.2000;13(4):288-292.
[30] 茹玉航.管状胃对食管癌切除术后患者生活质量的影响[J].实用癌症杂志,2013,28(4):376-378.
[31] Cheng Z,Qing CW, Peng YH, et al. Impact of the method of reconstruction after oncologic oesophagectomy on quality of life-a prospective,randomised study. Eur J Cardiothorac Surg.2011;39(1):109-114.
[32] Panebianco V, Francioni F, Anzidei M,et al.Magnetic resonance- fluoroscopy as long-term follow-up examination in patients with narrow gastric tube reconstruction after radical esophagectomy.Eur J Cardiothorac Surg. 2006;30(4): 663-668.