Al-Magedi Ahmed A S, Wu Rong, Tao Qingsong
Department of General Surgery, Affiliated Zhongda Hospital, School of Medicine, Southeast University, No. 87 dingjiaqiao, Nanjing, Jiangsu 210093, China.
Ann Med Surg (Lond). 2022 Mar 29;76:103558. doi: 10.1016/j.amsu.2022.103558. eCollection 2022 Apr.
Open gastrectomy"OG" compared with laparoscopic gastrectomy"LG" in patients with gastric cancer"GC" has been widely discussed over the past years. However, the lack of comparative analysis in postoperative pancreatic fistula "POPF" hinders its severity as surgical procedures developed rapidly. Therefore, there are still moot on whether one of these surgical options is superior in POPF.
To compare the incidence of POPF in patients undergoing OG and LG for gastric cancer "GC".
Articles from January 2011 to August 2021 that compared LG and OG for GC were reviewed. Cohort studies were included in our study. The quality of enrolled studies was evaluated. Outcomes regarding POPF complication and relative operation results were analyzed. Statistical analysis portrayed the Weighted mean difference"WMD"and the odds ratio"OR"with a 95% confidence interval "CI". The curative effect was analyzed using RevMan 5.4.1 software.
Totally 7 articles met the inclusion criteria, including 3194 patients with treatment of gastrectomy surgeries for gastric cancer "GC". There was no significant difference observed in POPF incidence (OR, 95% CI = 1.04 [0.74,1.46], P = 0.81) between OG group and LG group in patients undergoing GC gastrectomy.
We stringently explored the current incidence of POPF after GC gastrectomy, comparing its incidence during LG and OG, there was no significant difference between OG and LG in the incidence of POPF, and surgeons should give more concern for improvement in surgical techniques. Further research is still needed to explore the risk of causes and surgical techniques should be considered cautiously in a clinical procedure.
过去几年，胃癌患者行开放胃切除术（OG）与腹腔镜胃切除术（LG）的比较一直备受广泛讨论。然而，随着手术方式的快速发展，术后胰瘘（POPF）方面缺乏对比分析，这阻碍了对其严重程度的评估。因此，关于这两种手术方式在POPF方面哪种更具优势仍存在争议。
比较胃癌患者行OG和LG后POPF的发生率。
回顾2011年1月至2021年8月间比较LG和OG治疗胃癌的文章。纳入队列研究。评估纳入研究的质量。分析POPF并发症及相关手术结果的结局。统计分析采用加权均数差（WMD）和比值比（OR）及95%置信区间（CI）。使用RevMan 5.4.1软件分析疗效。
共7篇文章符合纳入标准，包括3194例行胃癌胃切除术治疗的患者。在接受胃癌胃切除术的患者中，OG组和LG组之间的POPF发生率无显著差异（OR，95%CI = 1.04 [0.74,1.46]，P = 0.81）。
我们严格探究了胃癌胃切除术后POPF的当前发生率，比较了LG和OG期间的发生率，OG和LG在POPF发生率上无显著差异，外科医生应更关注手术技术的改进。仍需进一步研究探索病因风险，在临床过程中应谨慎考虑手术技术。
