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：

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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.	陳萬青, 李賀, 孫可欣, 等. 2014年中國惡性腫瘤發病和死亡分析. 中華腫瘤雜志, 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.	何曉峰, 史敏科, 曹彬. 管狀胃在食管癌切除術中的應用進展. 中國胸心血管外科臨床雜志, 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.	李俊彥, 王勇, 劉偉良, 等. 管狀胃食管頸部分層吻合與機械吻合在食管癌手術中的應用比較. 中國胸心血管外科臨床雜志, 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.	藺瑞江, 胡文滕, 駱偉, 等. 管狀胃對食管癌患者術后并發癥和生活質量影響的Meta分析. 中國循證醫學雜志, 2014, 14(8): 950-957.
12.	劉蘭波, 齊海, 鄭實誼. 管狀胃與全胃相比較行消化道重建的Meta分析. 中國組織工程研究, 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, 黃建豪, 吳智勇, 等. 切除胃小彎的管狀胃加頸吻合治療胸段食管癌前瞻性研究. 中國基層醫藥, 2008, 15(1): 18-19.
17.	侯朋遠. 管狀胃與全胃代食管的食管癌切除術后患者生活質量狀況比較研究. 重慶醫科大學, 2009.
18.	彭林, 韓泳濤, 謝天鵬, 等. 管胃和全胃重建食管的隨機對照研究. 中國腫瘤臨床, 2009, 36(19): 1125-1127, 1131.
19.	伍傳新, 陳樹群, 林昱, 等. 管狀胃經食管床弓上吻合術對食管癌術后肺功能的影響. 中華胃腸外科雜志, 2010, 13(6): 450-451.
20.	梁海峰, 段林燦, 李高峰. 管狀胃與全胃代食管在食管癌頸部吻合中的應用研究. 中國社區醫師(醫學專業), 2011, 13(26): 54-55.
21.	吳慶琛. 管狀胃與全胃代食管的食管癌切除術后患者生活質量比較. 實用醫院臨床雜志, 2011, 8(5): 3-7.
22.	曹祥, 徐紹敢, 鄧波榮, 等. 管狀胃在食管癌切除消化道重建中的應用. 臨床外科雜志, 2013, 21(7): 530-531.
23.	李林峻, 吳慶琛, 張誠, 等. 食管癌切除不同消化道重建方式術后患者生命質量對比分析. 中華醫學雜志, 2013, 93(35): 2790-2793.
24.	何松林, 劉慧. 管狀胃對老年食管癌術后近期并發癥的影響. 中外醫學研究, 2014, 12(32): 134-135.
25.	黃國正, 李月明, 錢曉萍. 管狀胃在食管癌切除消化道重建術中的應用效果. 中國當代醫藥, 2014, 21(1): 62-63.
26.	莊敏, 吳月敏, 史建國. 應用管狀胃食管吻合術進行食管重建的效果研究. 當代醫藥論叢, 2014, 12(14): 294-295.
27.	卞世軍, 郭俊, 陳明會. 管狀胃成形重建食管在胸段食管癌切除術中的應用價值分析. 中國現代醫生, 2015, 53(23): 38-40, 43.
28.	何家賢, 陳桂榮, 黃俊, 等. 管狀胃在食管癌根治術中的應用. 廣西醫學, 2015, 37(5): 631-632.
29.	劉燦輝, 楊楠, 姚圣, 等. 管狀胃-食管吻合術對食管癌患者術后生活質量影響的前瞻性研究. 中國綜合臨床, 2015, 31(8): 731-734.
30.	劉建明. 管狀胃代食管術與全胃代食管術治療食管癌的臨床分析. 醫學信息, 2015, 28(43): 85-86.
31.	孟凡青, 周中民. 管狀胃-食管吻合術對食管癌根治術患者生活質量的影響. 癌癥進展, 2015, 13(1): 87-90.
32.	曹宇, 劉長江. 全胃代食管術與管狀胃代食管術治療食管癌的療效比較. 中國醫藥指南, 2016, 14(33): 73-73, 74.
33.	韓孔啟, 杜海生. 管狀胃對食管癌術后胃動力及胃排空功能的影響. 昆明醫科大學學報, 2016, 37(2): 89-92.
34.	景瑞軍, 李漢杰, 葛鵬, 等. 管狀胃代食管術與全胃代食管術治療食管癌的安全性與有效性對比. 現代生物醫學進展, 2016, 16(26): 5127-5130.
35.	居冠軍, 毛清華, 陸海敏, 等. 為食管癌患者采用管狀胃代食管術進行治療的效果分析. 當代醫藥論叢, 2016, 14(23): 67-68.
36.	李峰. 管狀胃成形重建食管在胸段食管癌切除術中的療效評價. 現代診斷與治療, 2016, 27(18): 3354-3356.
37.	王義勝. 管狀胃代食管術與全胃代食管術治療食管癌的療效對比. 醫學理論與實踐, 2016, 29(10): 1318-1319.
38.	于苗子, 劉朋濤, 許海偉. 管狀胃代食管吻合術與全胃手術治療食管癌的近期療效及安全性比較. 中國臨床新醫學, 2016, 9(12): 1142-1144.
39.	劉磊. 管狀胃代食管術與全胃代食管術治療食管癌的療效對比分析. 中國保健營養, 2017, 27(15): 58-59.
40.	李旭軍. 食管癌三切口管狀胃與全胃重建食管術的臨床療效比較. 醫藥前沿, 2018, 8(18): 228-229.
41.	梁錦. 用管狀胃代食管術治療食管癌的效果探究. 當代醫藥論叢, 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.	張曉彬, 楊煜, 孫益峰, 等. 經胸骨后與后縱隔管狀胃上提路徑對食管癌術后并發癥及近期生活質量影響的病例對照研究. 中國胸心血管外科臨床雜志, 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.	何曉峰, 史敏科, 曹彬. 管狀胃寬度對行Ivor-Lewis術后的食管癌患者生活質量的影響. 中華胃腸外科雜志, 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. 陳萬青, 李賀, 孫可欣, 等. 2014年中國惡性腫瘤發病和死亡分析. 中華腫瘤雜志, 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. 何曉峰, 史敏科, 曹彬. 管狀胃在食管癌切除術中的應用進展. 中國胸心血管外科臨床雜志, 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. 李俊彥, 王勇, 劉偉良, 等. 管狀胃食管頸部分層吻合與機械吻合在食管癌手術中的應用比較. 中國胸心血管外科臨床雜志, 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. 藺瑞江, 胡文滕, 駱偉, 等. 管狀胃對食管癌患者術后并發癥和生活質量影響的Meta分析. 中國循證醫學雜志, 2014, 14(8): 950-957.
12. 劉蘭波, 齊海, 鄭實誼. 管狀胃與全胃相比較行消化道重建的Meta分析. 中國組織工程研究, 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, 黃建豪, 吳智勇, 等. 切除胃小彎的管狀胃加頸吻合治療胸段食管癌前瞻性研究. 中國基層醫藥, 2008, 15(1): 18-19.
17. 侯朋遠. 管狀胃與全胃代食管的食管癌切除術后患者生活質量狀況比較研究. 重慶醫科大學, 2009.
18. 彭林, 韓泳濤, 謝天鵬, 等. 管胃和全胃重建食管的隨機對照研究. 中國腫瘤臨床, 2009, 36(19): 1125-1127, 1131.
19. 伍傳新, 陳樹群, 林昱, 等. 管狀胃經食管床弓上吻合術對食管癌術后肺功能的影響. 中華胃腸外科雜志, 2010, 13(6): 450-451.
20. 梁海峰, 段林燦, 李高峰. 管狀胃與全胃代食管在食管癌頸部吻合中的應用研究. 中國社區醫師(醫學專業), 2011, 13(26): 54-55.
21. 吳慶琛. 管狀胃與全胃代食管的食管癌切除術后患者生活質量比較. 實用醫院臨床雜志, 2011, 8(5): 3-7.
22. 曹祥, 徐紹敢, 鄧波榮, 等. 管狀胃在食管癌切除消化道重建中的應用. 臨床外科雜志, 2013, 21(7): 530-531.
23. 李林峻, 吳慶琛, 張誠, 等. 食管癌切除不同消化道重建方式術后患者生命質量對比分析. 中華醫學雜志, 2013, 93(35): 2790-2793.
24. 何松林, 劉慧. 管狀胃對老年食管癌術后近期并發癥的影響. 中外醫學研究, 2014, 12(32): 134-135.
25. 黃國正, 李月明, 錢曉萍. 管狀胃在食管癌切除消化道重建術中的應用效果. 中國當代醫藥, 2014, 21(1): 62-63.
26. 莊敏, 吳月敏, 史建國. 應用管狀胃食管吻合術進行食管重建的效果研究. 當代醫藥論叢, 2014, 12(14): 294-295.
27. 卞世軍, 郭俊, 陳明會. 管狀胃成形重建食管在胸段食管癌切除術中的應用價值分析. 中國現代醫生, 2015, 53(23): 38-40, 43.
28. 何家賢, 陳桂榮, 黃俊, 等. 管狀胃在食管癌根治術中的應用. 廣西醫學, 2015, 37(5): 631-632.
29. 劉燦輝, 楊楠, 姚圣, 等. 管狀胃-食管吻合術對食管癌患者術后生活質量影響的前瞻性研究. 中國綜合臨床, 2015, 31(8): 731-734.
30. 劉建明. 管狀胃代食管術與全胃代食管術治療食管癌的臨床分析. 醫學信息, 2015, 28(43): 85-86.
31. 孟凡青, 周中民. 管狀胃-食管吻合術對食管癌根治術患者生活質量的影響. 癌癥進展, 2015, 13(1): 87-90.
32. 曹宇, 劉長江. 全胃代食管術與管狀胃代食管術治療食管癌的療效比較. 中國醫藥指南, 2016, 14(33): 73-73, 74.
33. 韓孔啟, 杜海生. 管狀胃對食管癌術后胃動力及胃排空功能的影響. 昆明醫科大學學報, 2016, 37(2): 89-92.
34. 景瑞軍, 李漢杰, 葛鵬, 等. 管狀胃代食管術與全胃代食管術治療食管癌的安全性與有效性對比. 現代生物醫學進展, 2016, 16(26): 5127-5130.
35. 居冠軍, 毛清華, 陸海敏, 等. 為食管癌患者采用管狀胃代食管術進行治療的效果分析. 當代醫藥論叢, 2016, 14(23): 67-68.
36. 李峰. 管狀胃成形重建食管在胸段食管癌切除術中的療效評價. 現代診斷與治療, 2016, 27(18): 3354-3356.
37. 王義勝. 管狀胃代食管術與全胃代食管術治療食管癌的療效對比. 醫學理論與實踐, 2016, 29(10): 1318-1319.
38. 于苗子, 劉朋濤, 許海偉. 管狀胃代食管吻合術與全胃手術治療食管癌的近期療效及安全性比較. 中國臨床新醫學, 2016, 9(12): 1142-1144.
39. 劉磊. 管狀胃代食管術與全胃代食管術治療食管癌的療效對比分析. 中國保健營養, 2017, 27(15): 58-59.
40. 李旭軍. 食管癌三切口管狀胃與全胃重建食管術的臨床療效比較. 醫藥前沿, 2018, 8(18): 228-229.
41. 梁錦. 用管狀胃代食管術治療食管癌的效果探究. 當代醫藥論叢, 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. 張曉彬, 楊煜, 孫益峰, 等. 經胸骨后與后縱隔管狀胃上提路徑對食管癌術后并發癥及近期生活質量影響的病例對照研究. 中國胸心血管外科臨床雜志, 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.
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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

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