A-meta analysis of the Roux-en-Y versus BillrothIreconstruction in the treatment of distal gastric cancer

Abstract

Objective To conduct a meta-analysis to compare Roux-en-Y with Billroth Ⅰ anastomosis after distal gastrectomy for gastric cancer. Methods Trials were located through searches of the PubMed, CNKI, Medline, WANFANG, and Embase. In the randomized controlled trials of the two reconstruction methods Billroth Ⅰ and Roux-en-Y were included in the experiment, and the quality assessment and data extraction were carried out one by one. The operation time, intraoperative bleeding, operation time, intraoperative bleeding, postoperative hospital stay, postoperative recovery liquid diet time and postoperative nausea and vomiting, anastomotic leakage, anastomotic stenosis and postoperative changes of body weight, residual gastritis, reflux esophagitis, bile reflux and gastric emptying as evaluation index.RevMan 5.3 software was used for statistical analysis. Results Six randomized controlled trials involving 600 Patiernt. Meta-analysis revealed that Roun-en-Y reconstruction was associated with a reduced bile reflux [OR=30.31, 95%CI(8.74, 105.15), P<0.00001] and remnant gastritis [OR=2.73, 95%CI(1.86, 4.00), P<0.00 001], however needing a longer operation time [WMD=-30.82, 95%CI(-55.37, -6.26), P=0.01]. Conclusions This systematic review point towards some clinical advantages that are rendered by Roun-en-Y compared to Billroth I reconstruction post DG. However there is a need for further adequately powered, well designed RCTs comparing the same. Key words: Stomach neoplasms; Anastomosis; Roux-en-Y; BillrothⅠ; Distal gastrectomy; Meta-analysis; Randomized controlled trial