BACKGROUND: We performed a meta-analysis in an attempt to answer whether short-term outcomes and lymph nodes harvested after laparoscopy-assisted gastrectomy (LAG) are comparable to those reported after conventional open gastrectomy (COG). METHODS: Prospective randomized clinical trials were eligible if they included patients with distal gastric cancer treated by LAG versus COG. End points were operating time, intra-operative blood loss, size of wound, overall post-operative complications, time to first flatus, time to start oral intake, hospital stay and lymph nodes harvested. RESULTS: Six trials including 668 patients were included. For four of the 13 end points, the summary point estimates favoured LAG over COG; there was a significant reduction in intra-operative blood loss (weighted mean difference (WMD) −115.60, 95% confidence interval (CI) −159.16 to −72.04, P < 0.00001), size of wound (WMD −5.27, 95% CI −8.94 to −1.60, P= 0.005), overall post-operative complications (odds ratio 0.55, 95% CI 0.35 to 0.85, P = 0.008) and hospital stay (WMD −2.65, 95% CI −4.97 to −0.32, P= 0.03) for LAG. However, the combined results of the individual trials show significant longer operating time (WMD 112.98, 95% CI 60.32 to 165.64, P < 0.0001) and significant reduction in lymph nodes harvested (WMD −4.79, 95% CI −6.79 to −2.79, P < 0.00001) in the LAG group. There was no significant difference between the two groups in time to first flatus, time to start oral intake, wound infection, intra-abdominal fluid collection and abscess, anastomotic stenosis and leakage and pulmonary complications. CONCLUSION: The results of this meta-analysis suggest that LAG for early distal cancer is a feasible and safe alternative to COG, with better short-term outcomes.
BACKGROUND: We performed a meta-analysis in an attempt to answer whether short-term outcomes and lymph nodes harvested after laparoscopy-assisted gastrectomy (LAG) are comparable to those reported after conventional open gastrectomy (COG). METHODS: Prospective randomized clinical trials were eligible if they included patients with distal gastric cancer treated by LAG versus COG. End points were operating time, intra-operative blood loss, size of wound, overall post-operative complications, time to first flatus, time to start oral intake, hospital stay and lymph nodes harvested. RESULTS: Six trials including 668 patients were included. For four of the 13 end points, the summary point estimates favoured LAG over COG; there was a significant reduction in intra-operative blood loss (weighted mean difference (WMD) −115.60, 95% confidence interval (CI) −159.16 to −72.04, P < 0.00001), size of wound (WMD −5.27, 95% CI −8.94 to −1.60, P= 0.005), overall post-operative complications (odds ratio 0.55, 95% CI 0.35 to 0.85, P = 0.008) and hospital stay (WMD −2.65, 95% CI −4.97 to −0.32, P= 0.03) for LAG. However, the combined results of the individual trials show significant longer operating time (WMD 112.98, 95% CI 60.32 to 165.64, P < 0.0001) and significant reduction in lymph nodes harvested (WMD −4.79, 95% CI −6.79 to −2.79, P < 0.00001) in the LAG group. There was no significant difference between the two groups in time to first flatus, time to start oral intake, wound infection, intra-abdominal fluid collection and abscess, anastomotic stenosis and leakage and pulmonary complications. CONCLUSION: The results of this meta-analysis suggest that LAG for early distal cancer is a feasible and safe alternative to COG, with better short-term outcomes.
Authors: Stefano Caruso; Alberto Patriti; Franco Roviello; Lorenzo De Franco; Franco Franceschini; Andrea Coratti; Graziano Ceccarelli Journal: World J Gastroenterol Date: 2016-07-07 Impact factor: 5.742
Authors: Yu-Ling Huang; Hai-Guan Lin; Jian-Wu Yang; Fu-Quan Jiang; Tao Zhang; He-Ming Yang; Cheng-Lin Li; Yan Cui Journal: Int J Clin Exp Med Date: 2014-06-15