背景:胃癌的治疗包括肿瘤切除,其次是过境重建,Roux-en-Y是采用的主要技术。为了允许食物转运到十二指肠,这在Roux-en-Y中是不存在的,已经使用了双重过境重建,其理论优势似乎超过了以前的技术。
目的:比较胃癌患者行Roux-en-Y全胃切除术和双道重建术的临床演变。
方法:在WebofScience上进行了系统综述,Scopus,Embase,SciELO,虚拟健康图书馆,PubMed,科克伦,和谷歌学者数据库。数据收集到2022年6月11日。包括评估接受双道(DT)和Roux-en-Y(RY)重建的患者的观察性研究或临床试验。没有时间或语言限制。评论文章,病例报告,案例系列,不完整的文本被排除在外。使用为随机临床试验设计的Cochrane工具计算偏倚风险。
结果:纳入4项方法学质量良好的研究,包括209名参与者。在RY组,食物摄入量减少幅度更大。在DT组中,与术前相比,体重指数下降不明显.
结论:在体重指数和开始清淡饮食之前的时间方面,双道重建有更好的结果;然而,它在营养缺乏方面没有任何优势,生活质量,和术后并发症。
BACKGROUND: Curative treatment for gastric cancer involves tumor resection, followed by transit reconstruction, with Roux-en-Y being the main technique employed. To permit food transit to the duodenum, which is absent in Roux-en-Y, double transit reconstruction has been used, whose theoretical advantages seem to surpass the previous technique.
OBJECTIVE: To compare the clinical evolution of gastric cancer patients who underwent total gastrectomy with Roux-en-Y and double tract reconstruction.
METHODS: A systematic
review was carried out on Web of Science, Scopus, EmbasE, SciELO, Virtual Health Library, PubMed, Cochrane, and Google Scholar databases. Data were collected until June 11, 2022. Observational studies or clinical trials evaluating patients submitted to double tract (DT) and Roux-en-Y (RY) reconstructions were included. There was no temporal or language restriction.
Review articles, case reports, case series, and incomplete texts were excluded. The risk of bias was calculated using the Cochrane tool designed for randomized clinical trials.
RESULTS: Four studies of good methodological quality were included, encompassing 209 participants. In the RY group, there was a greater reduction in food intake. In the DT group, the decrease in body mass index was less pronounced compared to preoperative values.
CONCLUSIONS: The double tract reconstruction had better outcomes concerning body mass index and the time until starting a light diet; however, it did not present any advantages in relation to nutritional deficits, quality of life, and post-surgical complications.