Qing Liu1, Li Ding2, Honglei Jiang3, Chundong Zhang3, Junzhe Jin4. 1. Department of General Surgery, The Fourth Affiliated Hospital of China Medical University, No.4 Chongshan East Road, Huanggu District, Shenyang 110032, Liaoning Province, China; Department of General Surgery, Taikang Xianlin Drum Tower Hospital, No.188 Lingshan North Road, Qixia District, Nanjing, Jiangsu province, China. 2. Department of General Surgery, Taikang Xianlin Drum Tower Hospital, No.188 Lingshan North Road, Qixia District, Nanjing, Jiangsu province, China. 3. Department of General Surgery, The Fourth Affiliated Hospital of China Medical University, No.4 Chongshan East Road, Huanggu District, Shenyang 110032, Liaoning Province, China. 4. Department of General Surgery, The Fourth Affiliated Hospital of China Medical University, No.4 Chongshan East Road, Huanggu District, Shenyang 110032, Liaoning Province, China. Electronic address: jccccj@126.com.
Abstract
OBJECTIVE: To conduct a systematic review of efficacy and security of fast track surgery (FTS) in laparoscopic radical gastrectomy for gastric cancer. METHODS: We searched PubMed, Embase, and Cochrane Library Databases and supplemented by other searches to collect randomized controlled trials (RCTs) on the comparison of fast track surgery combined with laparoscopy versus laparoscopy separately used in radical gastrectomy for gastric cancer before December 2016. After screening for inclusion, data extraction, and quality assessment, meta-analysis was conducted by the Review Manager 5.3 software. RESULTS: A total of 6 RCTs, involving 464 patients, were included. There were 232 patients in the FTS group and conventional care group separately. Compared with the conventional care group, patients of FTS group had shorter postoperative hospital stay [WMD = -1.85, 95%CI: (-2.60, -1.11), P < .00001], earlier first flatus [WMD = -9.33, 95%CI: (-13.74, -4.91), P < .0001], lower level of C-reactive protein (CRP) at postoperative day 4 [WMD = -13.94, 95%CI: (-22.74, -5.15), P = .002], and less hospitalization fees [SMD = -1.12, 95%CI: (-2.07, -0.18), P = .02]. There were no significant differences in operation time, intraoperative blood loss, and postoperative complications between the two groups. CONCLUSION: Based on current evidence, the FTS protocol is safe and effective in laparoscopic radical gastrectomy for gastric cancer. Due to the limitations of our study, further larger and multicenter studies are needed to validate our findings.
OBJECTIVE: To conduct a systematic review of efficacy and security of fast track surgery (FTS) in laparoscopic radical gastrectomy for gastric cancer. METHODS: We searched PubMed, Embase, and Cochrane Library Databases and supplemented by other searches to collect randomized controlled trials (RCTs) on the comparison of fast track surgery combined with laparoscopy versus laparoscopy separately used in radical gastrectomy for gastric cancer before December 2016. After screening for inclusion, data extraction, and quality assessment, meta-analysis was conducted by the Review Manager 5.3 software. RESULTS: A total of 6 RCTs, involving 464 patients, were included. There were 232 patients in the FTS group and conventional care group separately. Compared with the conventional care group, patients of FTS group had shorter postoperative hospital stay [WMD = -1.85, 95%CI: (-2.60, -1.11), P < .00001], earlier first flatus [WMD = -9.33, 95%CI: (-13.74, -4.91), P < .0001], lower level of C-reactive protein (CRP) at postoperative day 4 [WMD = -13.94, 95%CI: (-22.74, -5.15), P = .002], and less hospitalization fees [SMD = -1.12, 95%CI: (-2.07, -0.18), P = .02]. There were no significant differences in operation time, intraoperative blood loss, and postoperative complications between the two groups. CONCLUSION: Based on current evidence, the FTS protocol is safe and effective in laparoscopic radical gastrectomy for gastric cancer. Due to the limitations of our study, further larger and multicenter studies are needed to validate our findings.
Authors: Luca Gianotti; Uberto Fumagalli Romario; Stefano De Pascale; Jacopo Weindelmayer; Valentina Mengardo; Marta Sandini; Andrea Cossu; Paolo Parise; Riccardo Rosati; Lapo Bencini; Andrea Coratti; Giovanni Colombo; Federica Galli; Stefano Rausei; Francesco Casella; Andrea Sansonetti; Dario Maggioni; Andrea Costanzi; Davide P Bernasconi; Giovanni De Manzoni Journal: World J Surg Date: 2019-10 Impact factor: 3.352
Authors: Michał Pędziwiatr; Judene Mavrikis; Jan Witowski; Alexandros Adamos; Piotr Major; Michał Nowakowski; Andrzej Budzyński Journal: Med Oncol Date: 2018-05-09 Impact factor: 3.064