Article Text
PDF
Abstract
Introduction Total gastrectomy is often recommended for upper body gastric cancer, and totally laparoscopic total gastrectomy (TLTG) is deemed to be a promising surgical method with the well-known advantages such as less invasion and fast recovery. However, the anastomosis between oesophagus and jejunum is the difficulty of TLTG. Although staplers have promoted the development of TLTG, the choice of suitable staplers to complete oesophagojejunostomy is controversial and unclear. Therefore, a higher level of research evidence is needed to compare the two types of staplers in terms of safety and efficacy for oesophagojejunostomy in TLTG among patients with gastric cancer.
Methods and analysis PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Wanfang Databases will be comprehensively searched from January 1990 to July 2019. All eligible randomised controlled trials (RCTs), non-RCTs or observational studies comparing the two types of staplers will be included. A meta-analysis will be performed using Review Manager V.5.3 software to compare the safety and efficacy of linear and circular staplers for oesophagojejunostomy in TLTG. The primary outcomes are anastomotic leakage, anastomotic stricture, anastomotic haemorrhage. The secondary outcomes include time to first instance of passing gas after surgery, first feeding time, total operation time, reconstruction time, estimated blood loss. The heterogeneity of this study will be assessed by p values and I2 statistic. Subgroup analyses and sensitivity analyses will be used to explore and explain the heterogeneity. The risk of bias will be assessed using the Cochrane tool or the Newcastle-Ottawa Quality Assessment Scale.
Ethics and dissemination Ethical approval will not be required because this proposed systematic review and meta-analysis is based on previously published data, which does not include intervention data on patients. The findings of this study will be submitted to a peer-reviewed journal and will be presented at a relevant congress.
PROSPERO registration number CRD42018111680.
- lnear stapler
- circular stapler
- totally laparoscopic total gastrectomy
- esophagojejunostomy
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Statistics from Altmetric.com
Footnotes
TL and LD contributed equally.
XY and MO contributed equally.
Contributors Wrote the paper: TL, LD. Study concept and design: MO, XY. Registered the protocol in the PROSPERO database: TL, MO. Preliminary literature search: TL, LD. Corrected and revised manuscript: MO, XY. Approving current version of manuscript: TL, LD, XY, MO.
Funding This study was financially supported by the Science and Technology Planning Project of Guangdong Province (No. 2014A020212053, No. 2014A020212636, No. 2016A020215128, No. 2017A030223006), the Medical Scientific Research Fund Project of the Guangdong Province (No. B2013374, No. A2014718, No. A2017160), the Research Startup Project of Shunde Hospital of Southern Medical University (No. SRSP2018001), the Science and Technology Bureau of Foshan City (No. 201308247), and the 13th Five-Year Key Specialty Project of Foshan City (FSGSPZD135051).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Patient consent for publication Not required.