Optimal reconstruction methods after distal gastrectomy for gastric cancer: A systematic review and network meta-analysis

Medicine
Zhaolun CaiBo Zhang

Abstract

The choice of anastomosis methods including Billroth I, Billroth II, and Roux-en-Y after a distal gastrectomy is still controversial. The conventional meta-analyses assessing 2 alternative treatments were not powered to compare differences in clinical outcomes. To guide treatment decisions in patients with gastric cancer (GC) after distal gastrectomy, we did a systematic review and network meta-analysis to identify the best reconstruction method. We systematically searched PubMed, EMBASE, the Cochrane Library for randomized controlled trials comparing the outcomes of Billroth I, Billroth II, or Roux-en-Y reconstruction after distal subtotal gastrectomy for patients with GC, then we performed a direct meta-analysis and Bayesian network meta-analysis to pooled odds ratios (OR) or weighted mean differences (WMD) with 95% credible intervals (CrI) with random effects model. The node-splitting method was used to assess the inconsistency. We estimated the potential ranking probability of treatments by calculating the surface under the cumulative ranking curve for each intervention. Nine studies involving 1161 patient were included in the network meta-analysis. Statistical significance was reached for the comparisons of Roux-en-Y versu...Continue Reading

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Citations

Apr 5, 2019·Journal of Gastric Cancer·UNKNOWN Guideline Committee of the Korean Gastric Cancer Association (KGCA), Development Working Group & Review Panel
Jul 17, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·You Na KimSung Kim
Feb 18, 2020·Gastric Cancer : Official Journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association·Koki NakanishiYasuhiro Kodera
Sep 10, 2019·Journal of Surgical Oncology·Keita SonodaJeannelyn S Estrella
Feb 7, 2020·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Masazumi SakaguchiSeiichiro Kanaya
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Sep 16, 2021·The Cochrane Database of Systematic Reviews·Daisuke NishizakiNorio Watanabe
Nov 3, 2021·Journal of the American Veterinary Medical Association·Marc A BarandunUlrich Rytz

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Methods Mentioned

BETA
surgical resection

Software Mentioned

JAGS
Stata
rjags
R
Cochrane Library ( Ovid )
gemtc
Cochrane

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