| Objective To systematically review the complications and quality of life(QoL) in patients with esophageal cancer after esophagectomy using gastric tube.Methods Randomized controlled trials(RCTs) about the postoperative complications and QoL of patients using gastric tube and the whole stomach reconstruction were electronically searched in PubMed, EMbase, The Cochrane Library, Web of Knowledge, CBM, CNKI, VIP and WanFang Data from inception to September 30 th,2013.Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality. Then meta-analysis was performed using RevMan 5.2 software.Results A total of 10 RCTs involving 1085 patients were included. The results of meta-analysis showed that, in terms of postoperative complications, the incidences of reflux esophagitis(OR=0.19, 95%CI 0.12 to 0.32, P<0.000 01) and intrathoracic stomach syndrome(OR=0.11, 95%CI 0.04 to 0.32, P<0.000 1) with gastric tube were significantly lower than those of the whole stomach; in terms of QoL, the scores of QoL in the 6th month(MD=18.71, 95%CI 7.72 to 29.71, P=0.000 9) and in the 12 th month(MD=22.95, 95%CI 8.21 to 37.69, P=0.002) with gastric tube were significantly higher than those of the whole stomach. In terms of satisfaction degree of QoL, the satisfaction degree of QoL in the 6th month(OR=1.78, 95%CI 1.10 to 2.88, P=0.02) and the 12 th month(OR=2.73, 95%CI 1.67 to 4.47, P<0.000 1) with gastric tube were both significantly higher than those of the whole stomach.Conclusion Compared with the whole stomach reconstruction, the method of gastric tube reconstruction has beneficial effects in reducing the incidences of postoperative complications(such as reflux esophagitis, intrathoracic stomach syndrome) and improves patients’ QoL. But there are many uncertain factors about postoperative anastomotic complication and its influence on patients’ long-term QoL remains uncertain. Thus, further studies should be conducted. |
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