近端胃切除术和全胃切除术治疗胃底贲门癌的meta分析

Meta-analysis of proximal gastrectomy and total gastrectomy for cancer of cardia and fundus

目的:评价近端胃切除术和全胃切除术治疗胃底贲门癌的价值。方法:收集公开发表的近端胃切除术和全胃切除术治疗胃底贲门癌的中文和外文文献,将文献中提取的数据按照其对应的术式分别纳入近端胃切除术组和全胃切除术组,对2组的并发症、病死率、5年生存率进行meta分析。结果:筛选出符合纳入标准的研究13项(2 219例),其中随机对照研究2项。近端胃切除术组和全胃切除术组并发症发生率(OR=1.00,95%CI:0.44～2.28,P>0.05)、病死率(OR=1.25,95%CI:0.62～2.48,P>0.05)的差异无统计学意义,5年生存率(HR=0.87,95%CI:0.76～0.99,P=0.04)的差异有统计学意义,全胃切除术组的5年生存率优于近端胃切除术。结论:全胃切除术治疗胃底贲门癌能够获得更好的远期疗效。

Objective To assess the value of proximal gastrectomy（PG） and total gastrectomy（TG） for the treatment of cancer of cardia and fundus.Methods Publications on comparision between PG and TG in the treatment of cancer of cardia and fundus were collected,the data from the publications were matched with the PG group and the TG group respectively according to its corresponding surgical resection,and the data on postoperative complications,motality and 5-year survival rate were meta-analyzed by fixed effect model and random effect model.Results Thirteen reseaches on 2 219 patients were included in this study,2 of which were randomly controlled studies.There were no significant differences in the postoperative complications（OR=1.00,95%CI： 0.44-2.28,P0.05） and mortality（OR=1.25,95%CI： 0.62-2.48,P0.05） between the PG group and the TG group,while there was significant difference in the 5-year survival rate（HR=0.87,95%CI： 0.76-0.99,P=0.04）.The 5-year survival rate in the TG group was higher than that in the PG group.Conclusion Total gastrectomy for the treatment of cancer of cardia and fundus has better long-term therapetic effect.