| Objective:The meta-analysis was performed to explore the best anastomosis after proximal gastrectomy by comparing esophagogastrostomy and jejunal interposition in patients with gastric cancer.Methods:PubMed?The Cochrane Library?EMBASE ?CNKI?WanFang Data Central were searched for comparing esophagogastrostomy and jejunal interposition after proximal gastrectomy.Two researchers independently screened the literatures,extracted the data,and assessed the risk of bias.Statistical analyses were carried out by the RevMan 5.3software.Results:Finally,12 literatures were included.The total sample size was 891 cases,including507 cases in esophagogastrostomy group and 384 cases in jejunal interposition group.The esophagogastrostomy group was superior to the jejunal interposition group in terms of operative time(MD=-49.26,95%CI:-70.32,-28.21,P<0.00001).The differences of intraoperative blood loss?postoperative hospital stay and the risk of postoperative complications(all P>0.05)was not statistically significant.The incidence of reflux esophagitis of conventional esophagogastrostomy group was significantly higher than jejunal interposition group(OR=3.30,95%CI:1.84,5.92,P<0.0001).Conclusion:Although jejunal interposition not predominate in terms of operative time compared with esophagogastrostomy,it not increase the intraoperative blood loss?postoperative hospital stay and risk of postoperative complications,and reduce the incidence of reflux esophagitis.Therefore,it is better to choose jejunal interposition after proximal gastrectomy. |
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