Complication Rates in Different Gastrectomy Techniques of Enhanced Recovery after Surgery for Gastric Cancer: A Meta-analysis

J Coll Physicians Surg Pak. 2022 Oct;32(10):1318-1325. doi: 10.29271/jcpsp.2022.10.1318.

Abstract

The purpose of this study was to analyse the postoperative complications of different gastrectomy methods, and provides guidance for the development of enhanced recovery after surgery (ERAS) protocols. We searched EMBASE, Web of Science, CINAHL, PubMed, MEDLINE, and the Cochrane Central Register of Controlled Trials for articles published from database inception to January 30, 2020. Statistical analysis was performed using R version 3.6.3 with single-rate meta-analysis. A total of 22 studies with 2127 patients were included. The types of postoperative complications showed that the pooled rate of nausea and vomiting was 10.22% (95% CI 4.56 to 17.48) and the pancreatic fistula was 3.58% (2.12 to 5.35) often occurred in patients who underwent laparoscopic gastrectomy (LG). After open gastrectomy (OG), postoperative urinary retention was 3.88% (0.00 to 13.17) and pancreatic fistula was 3.81% (1.78 to 6.42). The main complications of laparoscopic-assisted total gastrectomy and laparoscopic-assisted subtotal gastrectomy were pneumonia and pancreatic fistula, the rate was 3.19% (0.94 to 0.637) and 3.06% (0.11 to 8.36), respectively. In order to reduce the incidence of complications, ERAS should be revised from the aspects of rehabilitation, intraoperative application of new technology, shortening the operation time, early detection of high-risk groups, and implementation of audit. Key Words: Enhanced recovery after surgery, Gastric cancer, Postoperative complications.

Publication types

  • Meta-Analysis

MeSH terms

  • Enhanced Recovery After Surgery*
  • Gastrectomy / adverse effects
  • Gastrectomy / methods
  • Humans
  • Laparoscopy* / adverse effects
  • Laparoscopy* / methods
  • Length of Stay
  • Pancreatic Fistula
  • Postoperative Complications / etiology
  • Stomach Neoplasms* / surgery
  • Treatment Outcome