Systematic Review and Meta-analysis Comparing Proximal Gastrectomy with Double-tract-reconstruction and Total Gastrectomy in Gastric and Gastroesophageal Junction Cancer Patients: Still No Sufficient Evidence for Clinical Decision-making
Systematic Review and Meta-analysis Comparing Proximal Gastrectomy with Double-tract-reconstruction and Total Gastrectomy in Gastric and Gastroesophageal Junction Cancer Patients: Still No Sufficient Evidence for Clinical Decision-making

Author: Julian Hipp

Publisher:

Published: 2023

Total Pages: 0

ISBN-13:

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Abstract: Background To compare proximal gastrectomy with double-tract reconstruction and total gastrectomy in patients with gastroesophageal junction (AEG II-III) and gastric cancer. Methods We conducted systematic searches in Medline, Web of Science, and Cochrane Library until December 20, 2021 (PROSPERO registration number: CRD42021291500). Risk of bias was assessed using the revised Cochrane risk of bias tool and the ROBINS-I tool, as applicable. Evidence was rated by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Results One randomized controlled trial (RCT) and 13 non-RCTs with 1,317 patients (715 patients with total gastrectomy and 602 patients with proximal gastrectomy with double-tract reconstruction) were included. Patients treated by total gastrectomy had a significantly higher proportion of advanced cancer stages International Union Against Cancer IB-III (odds ratio: 0.68, 95% confidence interval: 0.51-0.91, P = .01). This heterogeneity biases the observed improved overall survival of patients after proximal gastrectomy with double-tract reconstruction (odds ratio: 0.67, 95% confidence interval: 0.44-1.01, P = .05). Both procedures were comparably efficient regarding perioperative parameters. Postoperative/preoperative bodyweight ratio (mean difference: 3.56, 95% confidence interval: 1.32-5.79, P = .002), postoperative/preoperative serum-hemoglobin ratio (mean difference 3.73, 95% confidence interval: 1.59-5.88, P .001), and postoperative serum vitamin B12 levels (mean difference 42.46, 95% confidence interval: 6.37-78.55, P = .02) were superior after proximal gastrectomy with double-tract reconstruction, while postoperative/preoperative serum-albumin ratio (mean difference 1.24, 95% confidence interval: -4.76 to 7.24, P = .69) and postoperative/preoperative serum total protein ratio (mean difference 1.12, 95% confidence interval: -2.77 to 5.00, P = .57) were not different. Health-related quality of life data were reported in only 2 studies, which found no significant advantages for proximal gastrectomy with double-tract reconstruction.brbrConclusion

Proximal Gastrectomy and Double-tract Reconstruction Vs Total Gastrectomy in Gastric and Gastro-esophageal Junction Cancer Patients — a Systematic Review and Meta-analysis Protocol (PROSPERO Registration Number: CRD42021291500)
Proximal Gastrectomy and Double-tract Reconstruction Vs Total Gastrectomy in Gastric and Gastro-esophageal Junction Cancer Patients — a Systematic Review and Meta-analysis Protocol (PROSPERO Registration Number: CRD42021291500)

Author: Julian Hipp

Publisher:

Published: 2023

Total Pages: 0

ISBN-13:

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Abstract: Background In Germany and Western Europe, gastroesophageal junction cancer (AEG) and proximal gastric cancer are currently treated with (transhiatal-extended) total gastrectomy (TG) according to the latest treatment guidelines. TG leads to a severe and long-lasting impairment of postoperative health-related quality of life (HRQoL) of the treated patients. Recent studies have suggested that HRQoL of these patients could be improved by proximal gastrectomy with double-tract reconstruction (PG-DTR) without compromising oncologic safety. Our aim is therefore to conduct a randomized controlled non-inferiority trial comparing PG-DTR with TG in AEG II/III and gastric cancer patients with overall survival as primary endpoint and HRQoL as key secondary endpoint. Methods This protocol is written with reference to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P 2015) statement. We will conduct searches in the electronic databases MEDLINE, Web of Science Core Collection, ScienceDirect, and Cochrane Library. We will also check references of relevant studies and perform a cited reference research. Titles and abstracts of the records identified by the searches will be screened, and full texts of all potentially relevant articles will be obtained. We will consider randomized trials and non-randomized studies. The selection of studies, data extraction, and assessment of risk of bias of the included studies will be conducted independently by two reviewers. Meta-analysis will be performed using RevMan 5.4 (Review Manager (RevMan) Version 5.4, The Cochrane Collaboration). Discussion This systematic review will identify the current study pool concerning the comparison of TG and PG-DTR and help to finally refine the research questions and to allow an evidence-based trial design of the planned multicenter randomized-controlled trial. Ethics and dissemination Ethical approval is not required for this systematic review. Study findings will be shared by publication in a peer-reviewed journal

Staging Laparoscopy
Staging Laparoscopy

Author: P. Hohenberger

Publisher: Springer Science & Business Media

Published: 2012-12-06

Total Pages: 206

ISBN-13: 3642562906

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Included here is a discussion of the pathophysiological aspects and risks of laparoscopic staging (such as trocar metastases) on the basis of international experience.

Total, Subtotal and Proximal Gastrectomy in Cancer
Total, Subtotal and Proximal Gastrectomy in Cancer

Author: Walter Siquini

Publisher: Springer

Published: 2015-05-05

Total Pages: 222

ISBN-13: 8847057493

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This richly illustrated volume describes the performance of total and subtotal gastrectomy with extended D2 lymphadenectomy by providing a detailed step-by-step guide to both manual and mechanical procedures. Gastric cancer is the fourth most commonly occurring cancer and the second most common cancer-related cause of death worldwide, and surgery remains the only potentially curative treatment. Although several aspects of surgical management are still controversial, all guidelines for the treatment of curable gastric cancer recommend subtotal gastrectomy (for tumors located in the antrum and corpus) or total gastrectomy (for tumors located in the fundus) with extended D2 lymphadenectomy. Various technical tips and secrets are revealed that serve to simplify the procedure and simultaneously make it more effective: by rendering esophagojejunal and gastrojejunal anastomosis more secure, the risk of leakage is minimized. High-quality intraoperative color photographs and drawings covering all steps facilitate understanding of these complex operations and will prove an invaluable tool for surgeons, residents and professionals in the field.

Operative Standards for Cancer Surgery
Operative Standards for Cancer Surgery

Author: American College of Surgeons Clinical Research Program

Publisher: Lippincott Williams & Wilkins

Published: 2015-05-28

Total Pages: 614

ISBN-13: 1496320387

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Presented by the American College of Surgeons and the Alliance for Clinical Trials in Oncology, the first comprehensive, evidence-based examination of cancer surgery techniques as standards distills the well-defined protocols and techniques that are critical to achieve optimal outcomes in a cancer operation. This unique, one of a kind collaboration between the American College of Surgeons and the Alliance for Clinical Trials in Oncology focuses on best practices and state-of-the-art methodologies. Operative Standards for Cancer Surgery clearly describes the surgical activities that occur between skin incision and skin closure that directly affect cancer outcomes.

Laparoscopic Gastrectomy for Gastric Cancer
Laparoscopic Gastrectomy for Gastric Cancer

Author: Chang-Ming Huang

Publisher: Springer

Published: 2015-05-05

Total Pages: 357

ISBN-13: 9401798737

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This book presents surgical techniques and detailed illustrations of laparoscopic gastrectomy for gastric cancer, focusing on effective, concise steps and techniques. It describes in detail the perigastric anatomy, and the incidences of each anatomical structure are analyzed statistically. It also discusses lessons learned and best practices in the management of gastric cancer patients, and includes video captures of precise operational techniques -essential resources for gastrointestinal laparoscopic surgeons. Given its close connection to clinical practice, it offers a valuable reference work for general surgeons and residents.​

Managing Failed Anti-Reflux Therapy
Managing Failed Anti-Reflux Therapy

Author: Mark K. Ferguson

Publisher: Springer Science & Business Media

Published: 2006-01-16

Total Pages: 194

ISBN-13: 1846280117

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Comprehensive and up-to-date analysis of GERD Has focus on remedies to failed treatment of the disease

Illustrative Handbook of General Surgery
Illustrative Handbook of General Surgery

Author: Herbert Chen

Publisher: Springer

Published: 2016-02-08

Total Pages: 801

ISBN-13: 3319245570

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This practical surgical atlas focuses on a variety of surgical procedures in a portable format, allowing students, residents and even attending surgeons to carry it around with them throughout the day to check up on operations at any given time. The comprehensive illustrations help the reader to understand the procedures described, thanks to inter-operative photographs which provide accurate representations of the various techniques of the operations. The wide scope of this book ensures coverage of the most common general surgery procedures and the most common operations that faculty, residents and students encounter.

Gastric Substitutes
Gastric Substitutes

Author: Jürg Metzger

Publisher: Springer

Published: 2012-12-06

Total Pages: 152

ISBN-13: 3642558801

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This book provides a survey for the gastric cancer surgeon. Two main chapters deal with resection and different types of reconstruction. Further contributions deal with clinical and pathological staging, imaging diagnostic tools, survival, and outcome after surgery, and adjuvant therapy. In particular the technique of the ileocolon interpositional graft for reconstruction is emphasized. This book is written for gastric surgeons, gastroenterologists, and oncologists. Numerous figures illustrate the different surgical techniques and explain the operative procedure step-by-step.

Minimally Invasive Cancer Management
Minimally Invasive Cancer Management

Author: Frederick L. Greene

Publisher: Springer Science & Business Media

Published: 2010-09-11

Total Pages: 374

ISBN-13: 144191238X

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As minimal access approaches to cancer diagnosis, staging, and therapy become more widely used, it is vital for general surgeons, along with laparoscopists, surgical oncologists and medical oncologists, to stay up to date. The editors, a team consisting of a renowned surgical oncologist and a laparoscopic specialist, aim to provide a resource for the practicing general surgeon using basic minimally invasive techniques. The book discusses diagnosis including biopsy with microinstrumentation, staging, and palliative and curative resection. Specific tumor sites are addressed, including esophagus, stomach, spleen, small bowel, pancreato-biliary, hepatic resection, and colo-rectal resection. Minimally invasive approaches to the thoracic and retroperitoneal areas are included. The book provides a thorough overview of basic cancer biology, instrumentation, and ultrasound. Additionally, Greene and Heniford explore controversial issues such as port-site recurrence and the effect of pneumoperitoneum on the spread of cancer cells in the abdomen. Many photographs and line drawings, including 16 in full color, illustrate the principles discussed in the text. A must-have for every practicing general surgeon, laparoscopic fellow, and general surgery resident.