Yao Wei1, Deliang Yu2, Yang Li3, Chaogang Fan4, Guoli Li4. 1. The First Affiliated Hospital of Soochow University, Department of Medicine, Emergency and Critical Care Medicine, 21503 Suzhou, China. 2. Division of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, 127, West Changle road, 710032 Xi'an, Shaanxi, China. 3. Division of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, 127, West Changle road, 710032 Xi'an, Shaanxi, China; Research Institute of General Surgery, Jinling Hospital, School of Medicine, Nanjing University, 305 Zhongshan Eastern road, 210002 Nanjing, China. Electronic address: li_yang82@icloud.com. 4. Research Institute of General Surgery, Jinling Hospital, School of Medicine, Nanjing University, 305 Zhongshan Eastern road, 210002 Nanjing, China.
Abstract
BACKGROUND: Additional studies comparing laparoscopic gastrectomy (LG) with open gastrectomy (OG) have been published, and the meta-analysis of this subject should be improved. METHODS: Randomized controlled trials and high-quality retrospective studies, which compared LG and OG for advanced gastric cancer (AGC) treatment and were published in English and Chinese between January 2000 and February 2017, were selected through PubMed, EMBASE, and the Cochrane Library database by two reviewers independently. The Jadad Composite Scale and the Newcastle-Ottawa scale were used to evaluate the quality and risk of bias for all included studies. Operative outcomes, postoperative outcomes, postoperative morbidity, harvested lymph nodes and 5-year overall survival (OS) were considered as primary endpoints and were compared. RESULTS: Fifteen studies including a total of 9337 cases (5000 in LG and 4337 in OG) were enrolled. LG showed longer operative time, less intraoperative blood loss, and quicker recovery after operations. Based on the subgroup analysis of the sample size, however, there was no difference in operative time between LG and OG. The number of harvested lymph nodes, 5-year OS, and postoperative morbidity were similar. CONCLUSION: LG can be performed as an alternative to OG for AGC, with quicker postoperative recovery and comparable safety and efficacy.
BACKGROUND: Additional studies comparing laparoscopic gastrectomy (LG) with open gastrectomy (OG) have been published, and the meta-analysis of this subject should be improved. METHODS: Randomized controlled trials and high-quality retrospective studies, which compared LG and OG for advanced gastric cancer (AGC) treatment and were published in English and Chinese between January 2000 and February 2017, were selected through PubMed, EMBASE, and the Cochrane Library database by two reviewers independently. The Jadad Composite Scale and the Newcastle-Ottawa scale were used to evaluate the quality and risk of bias for all included studies. Operative outcomes, postoperative outcomes, postoperative morbidity, harvested lymph nodes and 5-year overall survival (OS) were considered as primary endpoints and were compared. RESULTS: Fifteen studies including a total of 9337 cases (5000 in LG and 4337 in OG) were enrolled. LG showed longer operative time, less intraoperative blood loss, and quicker recovery after operations. Based on the subgroup analysis of the sample size, however, there was no difference in operative time between LG and OG. The number of harvested lymph nodes, 5-year OS, and postoperative morbidity were similar. CONCLUSION: LG can be performed as an alternative to OG for AGC, with quicker postoperative recovery and comparable safety and efficacy.
Authors: Zheng-Yan Li; Jie Chen; Bin Bai; Shuai Xu; Dan Song; Bo Lian; Ji-Peng Li; Gang Ji; Qing-Chuan Zhao Journal: Gastroenterol Rep (Oxf) Date: 2020-09-10