Total versus subtotal gastrectomy for distal gastric cancer: Meta-analysis of randomized clinical trials

OBJECTIVES: This meta-analysis of randomized controlled trials was conducted to give a more precise estimation of the efficacy and drawbacks of total gastrectomy (TG) versus subtotal gastrectomy (SG) for proven distal gastric cancer. METHODS: The electronic databases Cochrane and PubMed (updated on April 10, 2016) were searched for randomized controlled trials comparing TG with SG as surgical procedures for distal gastric cancer. Five outcome variables were analyzed, including postoperative complications, anastomotic fistula rate, hospital mortality rate, mortality rate of recurrence (the patient's death is caused by the recurrence of gastric cancer, rather than caused by other diseases), and 5-year survival rate. Random or fixed effect model was used to perform this meta-analysis. RESULTS: =0.03). CONCLUSION: This meta-analysis demonstrated that postoperative complications, hospital mortality rate, and 5-year survival rate in TG patients was similar to the SG group. Furthermore, SG was associated with significantly fewer anastomotic fistula and lower mortality rate of recurrence compared with TG. However, lower mortality rate of recurrence was probably related to the criteria of these two procedures.