title: Outcomes for jejunal interposition reconstruction compared with Roux-en-Y anastomosis: A meta-analysis.
abstract: OBJECTIVE
  To compare the clinical outcomes between jejunal interposition reconstruction and Roux-en-Y anastomosis after total gastrostomy in patients with gastric cancer.
  
  
  METHODS
  A systematic literature search was conducted by two independent researchers on PubMed, EMBASE, the Cochrane Library, Google Scholar, and other English literature databases, as well as the Chinese Academic Journal, Chinese Biomedical Literature Database, and other Chinese literature databases using "Gastrostomy", "Roux-en-Y", and "Interposition" as keywords. Data extraction and verification were performed on the literature included in this study. RevMan 5.2 software was used for data processing. A fixed-effects model was applied in the absence of heterogeneity between studies. A random effects model was applied in the presence of heterogeneity between studies.
  
  
  RESULTS
  Ten studies with a total of 762 gastric cancer patients who underwent total gastrostomy were included in this study. Among them, 357 received jejunal interposition reconstruction after total gastrostomy, and 405 received Roux-en-Y anastomosis. Compared with Roux-en-Y anastomosis, jejunal interposition reconstruction significantly decreased the incidence of dumping syndrome (OR = 0.18, 95%CI: 0.10-0.31; P < 0.001), increased the prognostic nutritional index [weighted mean difference (WMD) = 6.02, 95%CI: 1.82-10.22; P < 0.001], and improved the degree of postoperative weight loss [WMD = 2.47, 95%CI: -3.19-(-1.75); P < 0.001]. However, there is no statistically significant difference in operative time, hospital stay, or incidence of reflux esophagitis.
  
  
  CONCLUSIONS
  Compared with Roux-en-Y anastomosis, patients who underwent jejunal interposition reconstruction after total gastrostomy had a lower risk of postoperative long-term complications and improved life quality.
authors.affiliation: Kai-Xi Fan, Central Laboratory, Third Department of Medicine, Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan 250031, Shandong Province, China.
authors.forename: Kai-Xi
authors.initials: KX
authors.lastname: Fan
authors.affiliation: Kai-Xi Fan, Central Laboratory, Third Department of Medicine, Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan 250031, Shandong Province, China.
authors.forename: Zhong-Fa
authors.initials: ZF
authors.lastname: Xu
authors.affiliation: Kai-Xi Fan, Central Laboratory, Third Department of Medicine, Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan 250031, Shandong Province, China.
authors.forename: Mei-Rong
authors.initials: MR
authors.lastname: Wang
authors.affiliation: Kai-Xi Fan, Central Laboratory, Third Department of Medicine, Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan 250031, Shandong Province, China.
authors.forename: Dao-Tang
authors.initials: DT
authors.lastname: Li
authors.affiliation: Kai-Xi Fan, Central Laboratory, Third Department of Medicine, Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan 250031, Shandong Province, China.
authors.forename: Xiang-Shan
authors.initials: XS
authors.lastname: Yang
authors.affiliation: Kai-Xi Fan, Central Laboratory, Third Department of Medicine, Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan 250031, Shandong Province, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Guo
mesh_terms: D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects; D016009:Chi-Square Distribution; D005774:Gastrostomy / Q000009:adverse effects; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D009752:Nutritional Status; D016017:Odds Ratio; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Digestive tract reconstruction; Gastric cancer; Jejunal interposition reconstruction; Meta-analysis; Roux-en-Y anastomosis; Total gastrostomy