Systematic review and meta-analysis of perioperative compilations of hand-sewn esophagojejunostomy used for laparoscopic total gastrectomy

Background: We examine the perioperative complications of hand-sewn esophagojejunostomy (EJ) methods used for totally laparoscopic total gastrectomy (TLTG) for the treatment of gastric cancer. Methods: We reviewed PUBMED, EMBASE and the Cochrane Central Register for studies published from May 1998 to May 2018 to evaluate the perioperative complications of hand-sewn esophagojejunostomy applied for TLTG. Five studies were found to meet the inclusion criteria for our meta-analysis. After data extraction and quality assessment, we used Stata 12 to pool the data. Results: Five studies involving 234 patients were considered in our meta-analysis. The pooled data show an anastomotic leakage value of 1% (95% CI 0 to 4%) ，an anastomotic stricture value of 1% (95% CI 0 to 3%)，a conversion value of 0 and a postoperative bleeding value of 2% (95% CI 0 to 6%). Conclusions: TLTG involving intracorporeal hand-sewn end-to-side esophagojejunostomy serves as a safe approach to the treatment of gastric cancer. As this method is adopted by professionals, intracorporeally handsewn EJ could become an accepted means of executing widely used laparoscopic procedures of EJ.