Comparison of proximal gastrectomy and total gastrectomy in proximal gastric cancer: a meta-analysis of postoperative health condition using the PGSAS-45

Abstract Purpose Proximal gastrectomy (PG) offers advantages over total gastrectomy (TG) in enhancing the postoperative nutritional status of patients with proximal gastric cancer (PGC), yet its effect on long-term quality of life is still debated. This study aims to thoroughly compare postoperative...

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Main Authors: Xiangyu Yang, Zhili Zeng, Ziyue Liao, Caiyu Zhu, Hongyang Wang, Haijuan Wu, Shu Cao, Weizheng Liang, Xiushen Li
Format: Article
Language:English
Published: BMC 2024-10-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-024-13046-3
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author Xiangyu Yang
Zhili Zeng
Ziyue Liao
Caiyu Zhu
Hongyang Wang
Haijuan Wu
Shu Cao
Weizheng Liang
Xiushen Li
author_facet Xiangyu Yang
Zhili Zeng
Ziyue Liao
Caiyu Zhu
Hongyang Wang
Haijuan Wu
Shu Cao
Weizheng Liang
Xiushen Li
author_sort Xiangyu Yang
collection DOAJ
description Abstract Purpose Proximal gastrectomy (PG) offers advantages over total gastrectomy (TG) in enhancing the postoperative nutritional status of patients with proximal gastric cancer (PGC), yet its effect on long-term quality of life is still debated. This study aims to thoroughly compare postoperative health condition outcomes between PG and TG. Methods We conducted a systematic search of English-language articles from the PubMed, Web of Science, and Cochrane Library databases, covering studies published up to February 2023. Key evaluation endpoints included surgical outcomes and postoperative health condition, assessed using the Post-Gastrectomy Syndrome Assessment Scale-45 (PGSAS-45). Results Six retrospective cohort studies were included in the analysis. The PG group demonstrated no significant negative impact on surgical outcomes compared to the TG group. Notably, patients who underwent PG experienced a superior postoperative health condition, characterized by fewer gastroesophageal reflux symptoms (WMD = -0.106, 95% CI -0.183 to -0.029, P < 0.01), less weight loss (WMD = 4.440, 95% CI 3.900 to 4.979, P < 0.01), and reduced dietary dissatisfaction (WMD = -0.205, 95% CI -0.385 to -0.025, P = 0.03). Conclusion This study provides compelling evidence that PG is superior to TG in enhancing postoperative health condition for patients with proximal gastric cancer, without compromising surgical outcomes. However, further rigorous randomized controlled trials are necessary to inform surgical decision-making more effectively.
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spelling doaj-art-d95bae47ec1a4152b9090c27602dc49d2025-08-20T02:17:50ZengBMCBMC Cancer1471-24072024-10-0124111210.1186/s12885-024-13046-3Comparison of proximal gastrectomy and total gastrectomy in proximal gastric cancer: a meta-analysis of postoperative health condition using the PGSAS-45Xiangyu Yang0Zhili Zeng1Ziyue Liao2Caiyu Zhu3Hongyang Wang4Haijuan Wu5Shu Cao6Weizheng Liang7Xiushen Li8Department of Traditional Chinese Medicine, Jiangxi Maternal and Child Health HospitalDepartment of Breast Oncology, The Second Affiliated Hospital of Guangzhou University of Chinese MedicineDepartment of Gastroenterology and Hepatology, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Gastroenterology and Hepatology, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Gastroenterology and Hepatology, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Gastroenterology and Hepatology, The Second Affiliated Hospital of Chongqing Medical UniversityCollege of Traditional Chinese Medicine, Anhui University of Chinese MedicineCentral Laboratory, The First Affiliated Hospital of Hebei North UniversityDepartment of Traditional Chinese Medicine, Jiangxi Maternal and Child Health HospitalAbstract Purpose Proximal gastrectomy (PG) offers advantages over total gastrectomy (TG) in enhancing the postoperative nutritional status of patients with proximal gastric cancer (PGC), yet its effect on long-term quality of life is still debated. This study aims to thoroughly compare postoperative health condition outcomes between PG and TG. Methods We conducted a systematic search of English-language articles from the PubMed, Web of Science, and Cochrane Library databases, covering studies published up to February 2023. Key evaluation endpoints included surgical outcomes and postoperative health condition, assessed using the Post-Gastrectomy Syndrome Assessment Scale-45 (PGSAS-45). Results Six retrospective cohort studies were included in the analysis. The PG group demonstrated no significant negative impact on surgical outcomes compared to the TG group. Notably, patients who underwent PG experienced a superior postoperative health condition, characterized by fewer gastroesophageal reflux symptoms (WMD = -0.106, 95% CI -0.183 to -0.029, P < 0.01), less weight loss (WMD = 4.440, 95% CI 3.900 to 4.979, P < 0.01), and reduced dietary dissatisfaction (WMD = -0.205, 95% CI -0.385 to -0.025, P = 0.03). Conclusion This study provides compelling evidence that PG is superior to TG in enhancing postoperative health condition for patients with proximal gastric cancer, without compromising surgical outcomes. However, further rigorous randomized controlled trials are necessary to inform surgical decision-making more effectively.https://doi.org/10.1186/s12885-024-13046-3Proximal gastrectomyProximal gastric cancerPostoperative health conditionPGSAS-45Meta-analysis
spellingShingle Xiangyu Yang
Zhili Zeng
Ziyue Liao
Caiyu Zhu
Hongyang Wang
Haijuan Wu
Shu Cao
Weizheng Liang
Xiushen Li
Comparison of proximal gastrectomy and total gastrectomy in proximal gastric cancer: a meta-analysis of postoperative health condition using the PGSAS-45
BMC Cancer
Proximal gastrectomy
Proximal gastric cancer
Postoperative health condition
PGSAS-45
Meta-analysis
title Comparison of proximal gastrectomy and total gastrectomy in proximal gastric cancer: a meta-analysis of postoperative health condition using the PGSAS-45
title_full Comparison of proximal gastrectomy and total gastrectomy in proximal gastric cancer: a meta-analysis of postoperative health condition using the PGSAS-45
title_fullStr Comparison of proximal gastrectomy and total gastrectomy in proximal gastric cancer: a meta-analysis of postoperative health condition using the PGSAS-45
title_full_unstemmed Comparison of proximal gastrectomy and total gastrectomy in proximal gastric cancer: a meta-analysis of postoperative health condition using the PGSAS-45
title_short Comparison of proximal gastrectomy and total gastrectomy in proximal gastric cancer: a meta-analysis of postoperative health condition using the PGSAS-45
title_sort comparison of proximal gastrectomy and total gastrectomy in proximal gastric cancer a meta analysis of postoperative health condition using the pgsas 45
topic Proximal gastrectomy
Proximal gastric cancer
Postoperative health condition
PGSAS-45
Meta-analysis
url https://doi.org/10.1186/s12885-024-13046-3
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