Postoperative nutritional outcomes and quality of life-related complications of proximal versus total gastrectomy for upper-third early gastric cancer: a meta-analysis

source extracted confidence: high 2026-04-09
#esophagitis-peptic #gastrectomy #humans #postoperative-complications #postoperative-period

Postoperative nutritional outcomes and quality of life-related complications of proximal versus total gastrectomy for upper-third early gastric cancer: a meta-analysis

Lee et al., 2020 | Sci Rep | Meta Analysis

Citation

Lee Inhyeok, Oh Youjin, ... Park Sungsoo. Postoperative nutritional outcomes and quality of life-related complications of proximal versus total gastrectomy for upper-third early gastric cancer: a meta-analysis. Sci Rep. 2020-Dec-08;10(1):21460. doi:10.1038/s41598-020-78458-0

Abstract

Although proximal gastrectomy (PG) provides superior nutritional outcomes over total gastrectomy (TG) in upper-third early gastric cancer (EGC), surgeons are reluctant to perform PG due to the high rate of postoperative reflux. This meta-analysis aimed to comprehensively compare operative outcomes, nutritional outcomes, and quality of life-related complications between TG and PG performed with esophagogastrostomy (EG), jejunal interposition, or double-tract reconstruction (DTR) to reduce reflux after PG. After searching PubMed, Embase, Medline, and Web of Science databases, 25 studies comparing PG with TG in upper-third EGC published up to October 2020 were identified. PG with DTR was similar to TG regarding operative outcomes. Patients who underwent PG with DTR had less weight reduction (weighted mean difference [WMD] 4.29; 95% confidence interval [0.51-8.07]), reduced hemoglobin loss (WMD 5.74; [2.56-8.93]), and reduced vitamin B12 supplementation requirement (odds ratio [OR] 0.06; [0.00-0.89]) compared to patients who underwent TG. PG with EG caused more reflux (OR 5.18; [2.03-13.24]) and anastomotic stenosis (OR 3.94; [2.40-6.46]) than TG. However, PG with DTR was similar to TG regarding quality of life-related complications including reflux, anastomotic stenosis, and leakage. Hence, PG with DTR can be recommended for patients with upper-third EGC considering its superior postoperative nutritional outcomes.

Key Findings

Hence, PG with DTR can be recommended for patients with upper-third EGC considering its superior postoperative nutritional outcomes.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population upper
Sample Size 25
Age Range See abstract
Condition See abstract

MeSH Terms

  • Esophagitis, Peptic
  • Gastrectomy
  • Humans
  • Postoperative Complications
  • Postoperative Period
  • Quality of Life
  • Stomach
  • Stomach Neoplasms
  • Treatment Outcome

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't
  • Vertical: vitamin-b12

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09