title: Meta-analysis of pylorus-preserving gastrectomy for middle-third early gastric cancer.
abstract: BACKGROUND
  Pylorus-preserving gastrectomy (PPG) has been performed to reduce postprandial symptoms for some early gastric cancer (EGC) cases. The aim of this study was to evaluate the possible advantages after PPG for middle-third EGC in comparison with distal gastrectomy.
  
  
  METHODS
  We searched Medline, Embase, and Science Citation Index Expanded for relevant studies. Statistical analyses were conducted to calculate the summary weighted mean differences (WMDs) and odds ratios (ORs) with corresponding 95% confidence intervals (95% CIs) using random-effects models.
  
  
  RESULTS
  We identified 15 nonrandomized controlled trials (16 studies) with 1774 patients, which consisted of 11 studies for conventional PPG (CPPG) versus conventional distal gastrectomy (CDG) and 5 studies for laparoscopy-assisted PPG (LAPPG) versus laparoscopy-assisted distal gastrectomy (LADG). Meta-analysis of CPPG versus CDG revealed that CPPG had the advantage of prevention of early dumping syndrome (OR=0.18; 95% CI 0.12, 0.27), gastritis (OR=0.19; 95% CI 0.07, 0.53), duodenal juice reflux (OR=0.20; 95% CI 0.06, 0.66), and regaining of weight (WMD=3.53; 95% CI 2.34, 4.72). However, the incidence of gastric stasis was higher in the CPPG group than in the CDG group (OR=1.70; 95% CI 1.13, 2.57). Meta-analysis of LAPPG versus LADG revealed that LAPPG shortened the operation time (WMD=-21.12; 95% CI -31.33, -10.90) and did not increase the occurrence of postoperative complication (OR=0.72; 95% CI 0.41, 1.27).
  
  
  CONCLUSIONS
  With the benefits of prevention of early dumping syndrome, duodenal juice reflux, gastritis, and regaining of weight, PPG can be an excellent option for middle-third EGC.
authors.affiliation: 1 Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University , Nanjing, China .
authors.forename: Peng
authors.initials: P
authors.lastname: Song
authors.forename: Ming
authors.initials: M
authors.lastname: Lu
authors.forename: Fuxing
authors.initials: F
authors.lastname: Pu
authors.forename: Dong
authors.initials: D
authors.lastname: Zhang
authors.forename: Baolin
authors.initials: B
authors.lastname: Wang
authors.forename: Qinghong
authors.initials: Q
authors.lastname: Zhao
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D018849:Controlled Clinical Trials as Topic; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005763:Gastroenterostomy; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D059351:Organ Sparing Treatments / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D011708:Pylorus; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D015430:Weight Gain