SynthesisUpdates in surgery2026
Comparison on the reflux and nutritional status of different reconstruction methods after laparoscopic proximal gastrectomy: a systematic review and network meta-analysis.
Synthesis in Updates in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07635836 (Comparison of Gastroesophageal Reflux and Quality of Life Between Double-tract and Tubular Gastric Anastomosis in Proximal Gastric Cancer Patients), which is not on this map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Comparison of Gastroesophageal Reflux and Quality of Life Between Double-tract and Tubular Gastric Anastomosis in Proximal Gastric Cancer Patients
Who cites it
1 citing paper in PubMed.
- Application of modified π-shaped anastomosis in digestive tract reconstruction during totally laparoscopic total gastrectomy: a feasibility study.World journal of surgical oncology · 2026Article
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Authors and funding
8 authors.
Funding
Abstract
backgroundThe rising prevalence of gastric cancer in the upper third of the stomach has generated considerable interest in laparoscopic proximal gastrectomy (LPG). Traditional esophagogastric anastomosis after LPG has been associated with postoperative reflux issues. Despite the availability of various improved reconstruction techniques, there is still ongoing debate on the optimal approach. This network meta-analysis seeks to assess the reflux and nutritional outcomes associated with various reconstruction techniques subsequent to LPG.
methodsA comprehensive literature search was performed across five databases: PubMed, Medline, Embase, Cochrane Library, and Web of Science. The reconstruction methods following LPG include esophagogastrostomy (EG), jejunal interposition (JI), jejunal pouch interposition (JPI), double-flap technique (DFT), double-tract reconstruction (DTR), gastric tube reconstruction (GT), and side overlap with fundoplication by Yamashita (SOFY). Network meta-analyses were performed to consolidate outcome measures, such as reflux esophagitis (RE), postoperative reflux symptoms, and nutritional status.
resultsThis meta-analysis encompasses 16 studies published from 2009 to 2023, involving a total of 1,184 participants and examining 7 distinct reconstruction methods. The results indicated that patients who received DFT [odds ratio (OR) 13.27; 95% confidence interval (CI) 2.86-61.45] had a significantly lower rate of RE compared to those who underwent EG, as did patients who underwent SOFY (OR 4.58, 95% CI 1.16-18.10). Moreover, the DFT group demonstrated superior anti-reflux efficacy compared to the JI and DTR groups. Regarding nutritional status, both the JI group [standard mean difference (SMD) 12.16; 95% CI 3.57-20.76] and the DFT group (SMD 9.16; 95% CI 2.21-16.11) exhibited higher albumin levels compared to the EG interventions.
conclusionDFT has shown promising efficacy in anti-reflux and postoperative nutritional status. Furthermore, SOFY demonstrates efficacy in the management of reflux, whereas JI is linked to improved postoperative nutritional outcomes following LPG. While providing valuable insights, it is important to note that the comparative analyses of JPI and SOFY rely on single-trial data with modest sample sizes, which may affect the precision of comparative effect estimates. REGISTRATION: This network meta-analysis was registered on the PROSPERO (CRD42023414346).
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