title: Pouch Roux-en-Y vs No Pouch Roux-en-Y following total gastrectomy: a meta-analysis based on 12 studies.
abstract: After a total resection of the stomach, the continuity of the gastrointestinal tract can be restored either by Roux-en-Y esophagojejunostomy with or without a pouch. There is still no consensus on the best reconstruction technique. The aim of this report was to derive a more precise estimation of Roux-en-Y esophagojejunostomy with a pouch compared with Roux-en-Y esophagojejunostomy without a pouch. Studies were identified by PubMed and Embase searches, and the inclusion criteria were randomized controlled trials (RCTs) comparing reconstruction techniques between Roux-en-Y with and without a pouch. A total of 12 studies including 1,018 patients were included. The meta-analysis shows that pouch Roux-en-Y does not significantly increase total postoperative complications, anastomotic leakage or mortality. Importantly, there is no significant difference in 5-year survival rates between the two groups. Patients with Roux-en-Y esophagojejunostomy complained significantly less of reflux symptoms and dumping syndrome, and had significantly less severe reflux esophagitis. Quality of life was significantly improved in patients with Roux-en-Y esophagojejunostomy with a pouch compared with patients who received Roux-en-Y reconstruction without a pouch. The results indicate the need for Roux-en-Y esophagojejunostomy with a pouch is a gastric substitute after total gastrectomy by comparison with Roux-en-Y esophagojejunostomy without a pouch.
authors.affiliation: Department of Gastrointestinal Surgery, Subei People's Hospital of Jiangsu Province, Yangzhou, Jiangsu 225001, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Zong
authors.forename: Ping
authors.initials: P
authors.lastname: Chen
authors.forename: Yinbing
authors.initials: Y
authors.lastname: Chen
authors.forename: Guohao
authors.initials: G
authors.lastname: Shi
keywords: gastric cancer; meta-analysis; reconstruction; total gastrectomy
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