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- Title
HP09 *META-ANALYSIS OF D1 VERSUS D2 GASTRECTOMY FOR THE TREATMENT OF GASTRIC CARCINOMA.
- Authors
Siddaiah-Subramanya, M. B.; Hossain, M. B; Chakraborty, J.; Khan, S.; Memon, B.; Memon, M. A.
- Abstract
Purpose: The therapeutic benefit of D2 gastrectomy for gastric carcinoma has not been clearly demonstrated in RCTs. The aim was to conduct a meta-analysis of RCTs to investigate the merits of D1 versus D2 gastrectomy for the treatment of gastric cancer. Methodology: A search of Medline, Embase, Science Citation Index, Current Contents, PubMed and the Cochrane Database identified all RCTs comparing D1 versus D2 gastrectomy published in the English Language between 1980 and 2007. The six variables analysed included anastomotic leak, re-operation rate, overall complications, mortality, hospital stay and 5 year survival. Results: Six trials totalling 1591 patients (D1 = 813, D2 = 778) were analysed. There was a significant reduction of 60% in the relative odds of anastomotic leaks for D1, a significant reduction of 61% in relative odds of postoperative complications for D1, a significant lesser risk of 66% in the odds ratio of re-operation for D1 and a significant decrease of 7.15 days of duration of hospital stay for D1. The relative odds of mortality favoured D1 group (17% reduction of death) as well. Lastly the 5 year survival between the two groups was not different. Conclusion: Based on this meta-analysis, D1 gastrectomy is associated with significant fewer anastomotic leaks, postoperative complications; re-operation rate and decreased length of hospital stay. Furthermore the trend in mortality favoured D1 gastrectomy compared to D2 cohort. Lastly the five year survival in D1 gastrectomy patients was not compromised compared to D2 cohort.
- Subjects
META-analysis; CANCER treatment; GASTRIC mucosa; GASTRECTOMY; HOSPITAL admission &; discharge; SURGICAL complications; CANCER
- Publication
ANZ Journal of Surgery, 2009, Vol 79, pA40
- ISSN
1445-1433
- Publication type
Article
- DOI
10.1111/j.1445-2197.2009.04920_9.x