Outcomes of laparoscopic vs. open gastrectomy for Siewert type II/III adenocarcinoma of the esophagogastric junction: a systematic review and meta-analysis
Bibliographic record
Abstract
Background: Due to the special location of the adenocarcinoma of the esophagogastric junction (EGJ), there has been constant controversy regarding which surgical method should be adopted. We performed this meta-analysis to investigate the clinical efficacy and postoperative survival differences between laparoscopic gastrectomy (LG) and open gastrectomy (OG) in patients with Siewert type II/III adenocarcinoma of EGJ (AEG). Methods: We searched PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and Wanfang Database through April 2022. The intraoperative conditions and postoperative recovery of the two groups were compared. In addition, overall survival (OS) and disease-free survival (DFS) were the main indicators to evaluate the advantages and disadvantages of the two surgical methods. The final included literature was assessed by the Newcastle-Ottawa Scale, and publication bias was assessed by Funnel plot. Results: A total of 2,959 patients from 12 studies were included in the final meta-analysis, of which 1,601 patients were in the LG group and 1,358 patients were in the OG group. Compared with the OG group, the LG group patients had an increased number of dissected lymph nodes (LNs). The values of postoperative hospital stay, recovery time of gastrointestinal function, and incidence of postoperative complications in the LG group were smaller. In terms of 5-year OS [hazard ratio (HR) =0.68; 95% confidence interval (CI): 0.58, 0.81; P<0.00001] and DFS (HR =0.68; 95% CI: 0.59, 0.77; P<0.00001), patients in the LG group had a reduced risk. Conclusions: Compared with OG, LG is associated with less blood loss, fewer postoperative complications, more LNs dissected, and longer operation time, while showing significant advantages in OS and DFS.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.015 | 0.003 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".