Meta-analysis of laparoscopy-assisted distal gastrectomy and conventional open distal gastrectomy for early gastric cancer
- VernacularTitle:早期胃癌腹腔镜辅助远端胃切除术和传统开腹远端胃切除术的系统评价
- Author:
Peng JUN-SHENG
1
;
Song HU
;
Yang ZU-LI
;
Xiang JUN
;
Diao DE-CHANG
;
Liu ZHONG-HUI
Author Information
1. 中山大学附属第六医院
- Keywords:
Early gastric cancer;
laparoscopy-assisted distal gastrectomy;
conventional open distal gastrectomy;
meta-analysis
- From:Chinese Journal of Cancer
2010;29(4):381-387
- CountryChina
- Language:Chinese
-
Abstract:
Background and Objective: With the application of laparoscopy,laparoscopic gastrectomy for the treatment of patients with early gastric cancer has been performed,but the safety and effectiveness of this method needs to be explored.This study evaluated the safety and effectiveness of laparoscopy-assisted and conventional open distal gastrectomy for patients with early gastric cancer.Methods: A search of MEDLINE,EMBASE,the Chinese Biomedical Database(CBM),and Cochrane Central Register of Controlled Trials(CENTRAL)identified all the randomized clinical trials that compared laparoscopy-assisted gastrectomy with open distal gastrectomy for patients with early gastric cancer published in the last 10 years.Quality assessment was done on each trial and relevant data were extracted from qualified trials.Meta-analysis was performed using RevMan 4.2.2 software(Cochrane).Results: Six randomized controlled trials(RCTs)involving 218patients were included.Comparing laparoscopic resection with open resection,results showed less estimated blood loss[WMD(weighted mean difference):-121.86; 95% CI(confidence interval):-145.61,-98.11 ;P<0.001],earlier postoperative first flatus(WMD:-0.95; 95 % CI:-1.09,-0.81 ; P<0.001),and shorter durations of hospital stays(WMD:-2.27;95% CI:-3.47,-1.06; P=0.0002),but longer surgery times(WMD:58.71 ; 95 % CI: 52.69,64.74; P<0.001)and fewer lymph nodes dissected(WMD:-3.64; 95% CI:-5.80,-1.47; P=0.001).There was no significant difference between the two groups in postoperative complications[OR(odds ratio): 0.57; 95% CI: 0.31,1.03; P=0.06].Conclusion: The short-term outcome of laparoscopy-assisted distal gastrectomy for patients with early gastric cancer is superior to the open procedure,but its long-term outcome should be proven by further outcomes of RCTs.