Kamikawa anastomosis in proximal gastrectomy for gastric cancer: A systematic review and meta-analysis

Figure 1 Flow chart of the search for eligible studies.

Figure 2 Risk of bias plot following the Risk of Bias in Non-randomized Studies of Interventions tool for quality assessment.

Figure 3 Forest plot of surgical parameters. A: Operative time; B: Anastomosis time; C: Surgical bleeding; D: Number of lymph nodes harvested.

Figure 4 Forest plots of postoperative complications. A: Early postoperative complications; B: Severe complications (Clavien-Dindo grade ≥ III); C: Anastomotic leakage; D: Anastomotic bleeding; E: Anastomotic stenosis.

Figure 5 Forest plots of reflux-related complications and nutritional status at one year postoperatively. A: Reflux esophagitis; B: Subjective reflux symptoms; C: Proton pump inhibitor intake; D: Body weight loss.

Figure 6 Subgroup and sensitivity analyses of heterogeneity in early postoperative complications after Kamikawa anastomosis. A-C: Subgroup analyses evaluated potential sources of heterogeneity in the pooled incidence of early postoperative complications. Stratified variables included country of origin (A), publication year (B), and sample size (C); D: Sensitivity analysis employed a leave-one-out approach to assess the influence of individual studies on high heterogeneity.

Figure 7 Funnel plots. A: Early postoperative complications; B: Reflux esophagitis; C: Anastomotic stenosis.

Figure 8 Forest plots between the laparoscopic proximal gastrectomy-Kamikawa group and the laparoscopic proximal gastrectomy-double-tract construction group. A: Operative time; B: Anastomosis time; C: Surgical bleeding; D: Early complications; E: Reflux esophagitis; F: Anastomotic stenosis; G: Proton pump inhibitor intake.

Figure 9 Forest plots between the laparoscopic proximal gastrectomy-Kamikawa group and the laparoscopic total gastrectomy group. A: Operative time; B: Surgical bleeding; C: Hospital stay; D: Early complications; E: Reflux esophagitis; F: Anastomotic stenosis.