Impact of anastomotic leakage on survival after surgery for gastric carcinoma: A PRISMA systematic review and meta-analysis

BACKGROUND: The long-term survival of postoperative anastomotic leakage (AL) following gastric cancer (GC) surgery is still debating. Our aim was to investigate the association between AL and survival of the patients following GC. METHODS: We searched articles in databases from inception to July 2023 to retrieve literature related to postoperative AL and survival of GC patients. We evaluated the association of postoperative AL and survival of GC patients using the software STAT10.0. RESULTS: Seven articles with 6209 GC patients were included. Our results showed that the postoperative AL were associated with pooled 1-year patient overall survival (OS) result in an odds ratio (OR) of 0.504 (95% confidence interval (CI): 0.372–0.682; I(2) = 84.1%; P = .000), pooled 3-year patient OS (OR = 0.467, 95% CI: 0.356–0.614; I(2) = 85.3%; P = .000) and pooled 5-year patient OS (OR = 0.370, 95% CI: 0.171–0.805; I(2) = 82.5%; P = .012). The P value of Egger test were 0.759, 0.187, 0.175. The postoperative AL were associated with pooled 1-year patient disease-free survival (DFS) result in an OR of 0.538 (95% CI: 0.171–1.691; I(2) = 89.0%; P = .289), the pooled 3-year patient DFS (OR = 0.143, 95% CI: 0.119–1.431; I(2) = 91.7%; P = .163), and the pooled 5-year patient DFS (OR = 0.344, 95% CI: 0.088–1.338; I(2) = 91.0%; P = .124), and the P value of Egger test of pooled 1-, 3-, and 5-year DFS were 0.759, 0.247, 0.07. CONCLUSION: Postoperative AL was correlated with a worse OS in GC patients, but not correlated with DFS in GC patients, but more studies are required to confirm this conclusion.