Article Abstract

Pylorus-preserving gastrectomy versus distal gastrectomy in oncology for the patient with early gastric cancer: a meta-analysis

Authors: Tao Chen, Ziyu Chen, Li Zhen, Jiehui Zhong, Xingzuo Wang, Lili Xu, Xiaolong Qi


Background: The purpose of this study is to evaluate the early and late outcomes after pylorus-preserving gastrectomy (PPG) compares with distal gastrectomy (DG) in early gastric cancer (EGC).
Methods: We used PubMed, EMBASE, and the Cochrane Library to conduct a comprehensive search up to March 2016. All suitable studies comparing PPG with DG were included. Weighted mean difference (WMD), odds ratio (OR) and hazard ratio (HR) with corresponding 95% confidence intervals (95% CIs) were calculated in this meta-analysis.
Results: Sixteen studies of 2,066 EGC patients that compared PPG (n=685) with DG (n=1,381) were analyzed. As for early outcomes, analysis of PPG versus DG showed that PPG had shorter operative time (WMD =−12.84; 95% CI: −16.76 to −8.91, P<0.01). However, no significant differences were found for intraoperative blood loss (P=0.63), postoperative hospital stay (P=0.26), overall complication rate (P=0.67), or number of retrieved lymph nodes (P=0.21). In addition, analyses of late outcomes, including overall survival (OS), recurrence-free survival (RFS), recurrence and metastasis, indicated that all these outcomes had no significant difference between PPG and DG.
Conclusions: PPG has the advantage over DG in shorter operative time in EGC. Besides, there were no significant differences between PPG and DG in intraoperative blood loss, postoperative hospital stay, overall complication rate, number of retrieved lymph nodes, OS, RFS, recurrence and metastasis. More high quality trials are required to better evaluate early and late outcomes.