Clinical effect of tubular stomach and whole stomach reconstruction on esophageal carcinoma treatment: A systematic review and meta-analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WANG Bing ^1,2,3 , YAN Peijing ^3,4,5 , NIE Hongxin ¹ , JIN Dacheng ^1,2 , CHEN Meng ^1,2 , YANG Kehu ^3,4,5 ,  GOU Yunjiu ²

1. Department of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, 730000, P.R.China;
2. Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou, 730000, P.R.China;
3. Institution of Clinical Research and Evidence Based Medicine, Gansu Provincial Hospital, Lanzhou, 730000, P.R.China;
4. Evidence Based Medicine Center, Lanzhou University, Lanzhou, 730000, P.R.China;
5. Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, P.R.China;

Corresponding author：

GOU Yunjiu, Email: gouyunjiu@163.com

Keywords：

Esophagectomy; tubular stomach; whole stomach; systematic review/meta-analysis

DOI：

10.7507/1007-4848.201908010

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To systematically evaluate the efficacy of tubular stomach and whole stomach reconstruction in the treatment of esophageal cancer.Methods We searched PubMed, Web of Science, The Cochrane Library, EMbase, CNKI, Wanfang Data, VIP and CBM databases to collect the randomized controlled trial (RCT) studies on the efficacy comparison between tubular stomach and total gastric reconstruction of esophagus in esophagectomy from their date of inception to May 2019. Then meta-analysis was performed by using RevMan 5.3 software.Results A total of Twenty-nine RCTs were included, and 3 012 patients were involved. The results of meta-analysis showed that the postoperative complications such as anastomotic fistula [RR=0.64, 95%CI (0.50, 0.83), P=0.000 6], anastomotic stenosis [RR=0.65, 95%CI (0.50, 0.86), P=0.002], thoracic gastric syndrome [RR=0.19, 95%CI (0.13, 0.27), P<0.001], reflux esophagitis [RR=0.23, 95%CI (0.19, 0.30), P<0.001], gastric emptying disorder [RR=0.39, 95%CI (0.27, 0.57), P<0.001] and pulmonary infection [RR=0.44, 95%CI (0.31, 0.62), P<0.001] were significantly reduced, and the postoperative quality of life score and satisfaction were higher at 6 months and 1 year in the tubular stomach group (P<0.05). In terms of intraoperative blood loss and postoperative hospital stay, they were better in the tubular stomach group than those in the whole stomach group (P<0.05). However, there was no statistically significant difference between the two groups in operation time, postoperative gastrointestinal decompression time, postoperative closed drainage time, postoperative 1-year, 2-year and 3-year survival rate, postoperative quality of life score at 3 weeks and 3 months, and postoperative life satisfaction at 3 weeks.Conclusion The tubular stomach is more advantageous than the whole stomach in the reconstruction of esophagus after esophagectomy.

Citation： WANG Bing, YAN Peijing, NIE Hongxin, JIN Dacheng, CHEN Meng, YANG Kehu, GOU Yunjiu. Clinical effect of tubular stomach and whole stomach reconstruction on esophageal carcinoma treatment: A systematic review and meta-analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(5): 548-557. doi: 10.7507/1007-4848.201908010 Copy

1.	Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2.	陈万青, 李贺, 孙可欣, 等. 2014年中国恶性肿瘤发病和死亡分析. 中华肿瘤杂志, 2018, 40(1): 5-13.
3.	Best LM, Mughal M, Gurusamy KS. Non-surgical versus surgical treatment for oesophageal cancer. Cochrane Database Syst Rev, 2016, 3: CD011498.
4.	何晓峰, 史敏科, 曹彬. 管状胃在食管癌切除术中的应用进展. 中国胸心血管外科临床杂志, 2016, 23(2): 187-190.
5.	Zhang M, Li Q, Tie HT, et al. Methods of reconstruction after esophagectomy on long-term health-related quality of life: a prospective, randomized study of 5-year follow-up. Med Oncol, 2015, 32(4): 122.
6.	Gentile D, Riva P, Da Roit A, et al. Gastric tube cancer after esophagectomy for cancer: a systematic review. Dis Esophagus, 2019, 32: 1-8.
7.	Gooszen JAH, Goense L, Gisbertz SS, et al. Intrathoracic versus cervical anastomosis and predictors of anastomotic leakage after oesophagectomy for cancer. Br J Surg, 2018, 105(5): 552-560.
8.	李俊彦, 王勇, 刘伟良, 等. 管状胃食管颈部分层吻合与机械吻合在食管癌手术中的应用比较. 中国胸心血管外科临床杂志, 2017, 24(1): 61-64.
9.	Wang Z, Zhang H, Wang F, et al. Robot-assisted esophagogastric reconstruction in minimally invasive Ivor Lewis esophagectomy. J Thorac Dis, 2019, 11(5): 1860-1866.
10.	Guo W, Yang S, Li H. Esophagectomy with gastric conduit reconstruction for benign disease: extreme but important. Ann Transl Med, 2018, 6(7): 117.
11.	蔺瑞江, 胡文滕, 骆伟, 等. 管状胃对食管癌患者术后并发症和生活质量影响的Meta分析. 中国循证医学杂志, 2014, 14(8): 950-957.
12.	刘兰波, 齐海, 郑实谊. 管状胃与全胃相比较行消化道重建的Meta分析. 中国组织工程研究, 2015, 19(2): 316-321.
13.	Zhang C, Wu QC, Hou PY, 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.
14.	Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol, 2005, 5: 13.
15.	Tabira Y, Sakaguchi T, Kuhara H, et al. The width of a gastric tube has no impact on outcome after esophagectomy. Am J Surg, 2004, 187(3): 417-421.
16.	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. 中国基层医药, 2008, 15(1): 18-19.
17.	侯朋远. 管状胃与全胃代食管的食管癌切除术后患者生活质量状况比较研究. 重庆医科大学, 2009.
18.	彭林, 韩泳涛, 谢天鹏, 等. 管胃和全胃重建食管的随机对照研究. 中国肿瘤临床, 2009, 36(19): 1125-1127, 1131.
19.	伍传新, 陈树群, 林昱, 等. 管状胃经食管床弓上吻合术对食管癌术后肺功能的影响. 中华胃肠外科杂志, 2010, 13(6): 450-451.
20.	梁海峰, 段林灿, 李高峰. 管状胃与全胃代食管在食管癌颈部吻合中的应用研究. 中国社区医师(医学专业), 2011, 13(26): 54-55.
21.	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. 实用医院临床杂志, 2011, 8(5): 3-7.
22.	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. 临床外科杂志, 2013, 21(7): 530-531.
23.	李林峻, 吴庆琛, 张诚, 等. 食管癌切除不同消化道重建方式术后患者生命质量对比分析. 中华医学杂志, 2013, 93(35): 2790-2793.
24.	何松林, 刘慧. 管状胃对老年食管癌术后近期并发症的影响. 中外医学研究, 2014, 12(32): 134-135.
25.	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. 中国当代医药, 2014, 21(1): 62-63.
26.	庄敏, 吴月敏, 史建国. 应用管状胃食管吻合术进行食管重建的效果研究. 当代医药论丛, 2014, 12(14): 294-295.
27.	卞世军, 郭俊, 陈明会. 管状胃成形重建食管在胸段食管癌切除术中的应用价值分析. 中国现代医生, 2015, 53(23): 38-40, 43.
28.	何家贤, 陈桂荣, 黄俊, 等. 管状胃在食管癌根治术中的应用. 广西医学, 2015, 37(5): 631-632.
29.	刘灿辉, 杨楠, 姚圣, 等. 管状胃-食管吻合术对食管癌患者术后生活质量影响的前瞻性研究. 中国综合临床, 2015, 31(8): 731-734.
30.	刘建明. 管状胃代食管术与全胃代食管术治疗食管癌的临床分析. 医学信息, 2015, 28(43): 85-86.
31.	孟凡青, 周中民. 管状胃-食管吻合术对食管癌根治术患者生活质量的影响. 癌症进展, 2015, 13(1): 87-90.
32.	曹宇, 刘长江. 全胃代食管术与管状胃代食管术治疗食管癌的疗效比较. 中国医药指南, 2016, 14(33): 73-73, 74.
33.	韩孔启, 杜海生. 管状胃对食管癌术后胃动力及胃排空功能的影响. 昆明医科大学学报, 2016, 37(2): 89-92.
34.	景瑞军, 李汉杰, 葛鹏, 等. 管状胃代食管术与全胃代食管术治疗食管癌的安全性与有效性对比. 现代生物医学进展, 2016, 16(26): 5127-5130.
35.	居冠军, 毛清华, 陆海敏, 等. 为食管癌患者采用管状胃代食管术进行治疗的效果分析. 当代医药论丛, 2016, 14(23): 67-68.
36.	李峰. 管状胃成形重建食管在胸段食管癌切除术中的疗效评价. 现代诊断与治疗, 2016, 27(18): 3354-3356.
37.	王义胜. 管状胃代食管术与全胃代食管术治疗食管癌的疗效对比. 医学理论与实践, 2016, 29(10): 1318-1319.
38.	于苗子, 刘朋涛, 许海伟. 管状胃代食管吻合术与全胃手术治疗食管癌的近期疗效及安全性比较. 中国临床新医学, 2016, 9(12): 1142-1144.
39.	刘磊. 管状胃代食管术与全胃代食管术治疗食管癌的疗效对比分析. 中国保健营养, 2017, 27(15): 58-59.
40.	李旭军. 食管癌三切口管状胃与全胃重建食管术的临床疗效比较. 医药前沿, 2018, 8(18): 228-229.
41.	梁锦. 用管状胃代食管术治疗食管癌的效果探究. 当代医药论丛, 2018, 16(4): 84-85.
42.	Wang S, Lin S, Wang H, et al. Reconstruction methods after radical proximal gastrectomy: A systematic review. Medicine (Baltimore), 2018, 97(11): e0121.
43.	张晓彬, 杨煜, 孙益峰, 等. 经胸骨后与后纵隔管状胃上提路径对食管癌术后并发症及近期生活质量影响的病例对照研究. 中国胸心血管外科临床杂志, 2018, 25(2): 143-147.
44.	Park SY, Kim DJ, Suh JW, et al. Risk factors for weight loss 1 year after esophagectomy and gastric pull-up for esophageal cancer. J Gastrointest Surg, 2018, 22(7): 1137-1143.
45.	Shirakawa Y, Noma K, Maeda N, et al. Clinical characteristics and management of gastric tube cancer after esophagectomy. Esophagus, 2018, 15(3): 180-189.
46.	何晓峰, 史敏科, 曹彬. 管状胃宽度对行Ivor-Lewis术后的食管癌患者生活质量的影响. 中华胃肠外科杂志, 2018, 21(9): 1001-1007.
47.	Abe T, Fukaya M, Nagino M. Retrosternal salvage reconstruction of esophageal discontinuity for a necrotic gastric tube after esophagectomy: A novel procedure. J Med Invest, 2018, 65(3.4): 296-298.

1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2. 陈万青, 李贺, 孙可欣, 等. 2014年中国恶性肿瘤发病和死亡分析. 中华肿瘤杂志, 2018, 40(1): 5-13.
3. Best LM, Mughal M, Gurusamy KS. Non-surgical versus surgical treatment for oesophageal cancer. Cochrane Database Syst Rev, 2016, 3: CD011498.
4. 何晓峰, 史敏科, 曹彬. 管状胃在食管癌切除术中的应用进展. 中国胸心血管外科临床杂志, 2016, 23(2): 187-190.
5. Zhang M, Li Q, Tie HT, et al. Methods of reconstruction after esophagectomy on long-term health-related quality of life: a prospective, randomized study of 5-year follow-up. Med Oncol, 2015, 32(4): 122.
6. Gentile D, Riva P, Da Roit A, et al. Gastric tube cancer after esophagectomy for cancer: a systematic review. Dis Esophagus, 2019, 32: 1-8.
7. Gooszen JAH, Goense L, Gisbertz SS, et al. Intrathoracic versus cervical anastomosis and predictors of anastomotic leakage after oesophagectomy for cancer. Br J Surg, 2018, 105(5): 552-560.
8. 李俊彦, 王勇, 刘伟良, 等. 管状胃食管颈部分层吻合与机械吻合在食管癌手术中的应用比较. 中国胸心血管外科临床杂志, 2017, 24(1): 61-64.
9. Wang Z, Zhang H, Wang F, et al. Robot-assisted esophagogastric reconstruction in minimally invasive Ivor Lewis esophagectomy. J Thorac Dis, 2019, 11(5): 1860-1866.
10. Guo W, Yang S, Li H. Esophagectomy with gastric conduit reconstruction for benign disease: extreme but important. Ann Transl Med, 2018, 6(7): 117.
11. 蔺瑞江, 胡文滕, 骆伟, 等. 管状胃对食管癌患者术后并发症和生活质量影响的Meta分析. 中国循证医学杂志, 2014, 14(8): 950-957.
12. 刘兰波, 齐海, 郑实谊. 管状胃与全胃相比较行消化道重建的Meta分析. 中国组织工程研究, 2015, 19(2): 316-321.
13. Zhang C, Wu QC, Hou PY, 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.
14. Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol, 2005, 5: 13.
15. Tabira Y, Sakaguchi T, Kuhara H, et al. The width of a gastric tube has no impact on outcome after esophagectomy. Am J Surg, 2004, 187(3): 417-421.
16. 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. 中国基层医药, 2008, 15(1): 18-19.
17. 侯朋远. 管状胃与全胃代食管的食管癌切除术后患者生活质量状况比较研究. 重庆医科大学, 2009.
18. 彭林, 韩泳涛, 谢天鹏, 等. 管胃和全胃重建食管的随机对照研究. 中国肿瘤临床, 2009, 36(19): 1125-1127, 1131.
19. 伍传新, 陈树群, 林昱, 等. 管状胃经食管床弓上吻合术对食管癌术后肺功能的影响. 中华胃肠外科杂志, 2010, 13(6): 450-451.
20. 梁海峰, 段林灿, 李高峰. 管状胃与全胃代食管在食管癌颈部吻合中的应用研究. 中国社区医师(医学专业), 2011, 13(26): 54-55.
21. 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. 实用医院临床杂志, 2011, 8(5): 3-7.
22. 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. 临床外科杂志, 2013, 21(7): 530-531.
23. 李林峻, 吴庆琛, 张诚, 等. 食管癌切除不同消化道重建方式术后患者生命质量对比分析. 中华医学杂志, 2013, 93(35): 2790-2793.
24. 何松林, 刘慧. 管状胃对老年食管癌术后近期并发症的影响. 中外医学研究, 2014, 12(32): 134-135.
25. 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. 中国当代医药, 2014, 21(1): 62-63.
26. 庄敏, 吴月敏, 史建国. 应用管状胃食管吻合术进行食管重建的效果研究. 当代医药论丛, 2014, 12(14): 294-295.
27. 卞世军, 郭俊, 陈明会. 管状胃成形重建食管在胸段食管癌切除术中的应用价值分析. 中国现代医生, 2015, 53(23): 38-40, 43.
28. 何家贤, 陈桂荣, 黄俊, 等. 管状胃在食管癌根治术中的应用. 广西医学, 2015, 37(5): 631-632.
29. 刘灿辉, 杨楠, 姚圣, 等. 管状胃-食管吻合术对食管癌患者术后生活质量影响的前瞻性研究. 中国综合临床, 2015, 31(8): 731-734.
30. 刘建明. 管状胃代食管术与全胃代食管术治疗食管癌的临床分析. 医学信息, 2015, 28(43): 85-86.
31. 孟凡青, 周中民. 管状胃-食管吻合术对食管癌根治术患者生活质量的影响. 癌症进展, 2015, 13(1): 87-90.
32. 曹宇, 刘长江. 全胃代食管术与管状胃代食管术治疗食管癌的疗效比较. 中国医药指南, 2016, 14(33): 73-73, 74.
33. 韩孔启, 杜海生. 管状胃对食管癌术后胃动力及胃排空功能的影响. 昆明医科大学学报, 2016, 37(2): 89-92.
34. 景瑞军, 李汉杰, 葛鹏, 等. 管状胃代食管术与全胃代食管术治疗食管癌的安全性与有效性对比. 现代生物医学进展, 2016, 16(26): 5127-5130.
35. 居冠军, 毛清华, 陆海敏, 等. 为食管癌患者采用管状胃代食管术进行治疗的效果分析. 当代医药论丛, 2016, 14(23): 67-68.
36. 李峰. 管状胃成形重建食管在胸段食管癌切除术中的疗效评价. 现代诊断与治疗, 2016, 27(18): 3354-3356.
37. 王义胜. 管状胃代食管术与全胃代食管术治疗食管癌的疗效对比. 医学理论与实践, 2016, 29(10): 1318-1319.
38. 于苗子, 刘朋涛, 许海伟. 管状胃代食管吻合术与全胃手术治疗食管癌的近期疗效及安全性比较. 中国临床新医学, 2016, 9(12): 1142-1144.
39. 刘磊. 管状胃代食管术与全胃代食管术治疗食管癌的疗效对比分析. 中国保健营养, 2017, 27(15): 58-59.
40. 李旭军. 食管癌三切口管状胃与全胃重建食管术的临床疗效比较. 医药前沿, 2018, 8(18): 228-229.
41. 梁锦. 用管状胃代食管术治疗食管癌的效果探究. 当代医药论丛, 2018, 16(4): 84-85.
42. Wang S, Lin S, Wang H, et al. Reconstruction methods after radical proximal gastrectomy: A systematic review. Medicine (Baltimore), 2018, 97(11): e0121.
43. 张晓彬, 杨煜, 孙益峰, 等. 经胸骨后与后纵隔管状胃上提路径对食管癌术后并发症及近期生活质量影响的病例对照研究. 中国胸心血管外科临床杂志, 2018, 25(2): 143-147.
44. Park SY, Kim DJ, Suh JW, et al. Risk factors for weight loss 1 year after esophagectomy and gastric pull-up for esophageal cancer. J Gastrointest Surg, 2018, 22(7): 1137-1143.
45. Shirakawa Y, Noma K, Maeda N, et al. Clinical characteristics and management of gastric tube cancer after esophagectomy. Esophagus, 2018, 15(3): 180-189.
46. 何晓峰, 史敏科, 曹彬. 管状胃宽度对行Ivor-Lewis术后的食管癌患者生活质量的影响. 中华胃肠外科杂志, 2018, 21(9): 1001-1007.
47. Abe T, Fukaya M, Nagino M. Retrosternal salvage reconstruction of esophageal discontinuity for a necrotic gastric tube after esophagectomy: A novel procedure. J Med Invest, 2018, 65(3.4): 296-298.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical effect of tubular stomach and whole stomach reconstruction on esophageal carcinoma treatment: A systematic review and meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content