A Meta-analysis About The Safety And Efficiency Of Roux-en-Y Versus Billroth-I Procedure For Alimentary Continuity Reconstruction In Radical Gastrectomy

Background and Objective:Gastric cancer is one of the malignant tumors with a high clinical incidence.The mortality rate of the disease is high,and the cure rate is low.At present,the clinical treatment of gastric cancer includes surgery,chemotherapy,targeted therapy,and immunotherapy.The subtotal gastrectomy as a kind of traumatic treatment often brings some complications after surgery.Therefore,how to choose the way of gastro-subtotal gastrectomy to reduce the complications caused by surgery is very important.To investigate the safety and efficacy of Roux-en-Y versus Billroth-? procedures for alimentary continuity reconstruction in radical gastrectomy.Methods:We searched databases including Web of Science,PubMed,Wanfang database,CBM,and CNKI databases.After selecting qualified documents and making methodological assessments.RevMan 5.3 software was used for meta-analysis.Results:A total of 45 first-time relevant literatures were reviewed.After reading abstracts,literatures that did not clearly meet the inclusion criteria were excluded.A total of 7 studies were included involving 1055 patients.There were 459 patients in the Billroth-? group and 596 patients in the Roux-en-Y group.The results of meta-an-alysis showed that the operative time in the Billroth-? group was significantly shorter than that in the Roux-en-Y group(95%CI-45.15 ~-34.08,P<0.00001).The Intraoperative hemorrhage in the Billroth-? group was significantly less than that in the Roux-en-Y group(95%CI-57.48~-49.35,P<0.05)The average hospitalization days in the Billroth-? group were significantly shorter than that in the Roux-en-Y group(95%CI-1.42~-0.63,P<0.05).The incidence of residual gastritis in the Roux-en-Y group were significantly lower than that in the Billroth-? group(P<0.05).There was no statistical difference in the incidence of anastomotic leakage(P=0.79)and dumping syndrome(P=0.99).Conclusion: Current evidence indicate that compared with Roux-en-Y approach,patients treated by Billroth-? approach for alimentary continuity reconstruction in radical gastrectomy possessed shorter operative time,less intraoperative hemorrhage and shorter average hospitalization days,however,the incidence of residual gastritis is high.