Surgical Endoscopy

, Volume 27, Issue 7, pp 2466–2480

Laparoscopy-assisted gastrectomy versus open gastrectomy for resectable gastric cancer: an update meta-analysis based on randomized controlled trials

  • Lei Jiang
  • Ke-Hu Yang
  • Quan-Lin Guan
  • Nong Cao
  • Yan Chen
  • Peng Zhao
  • Yao-Long Chen
  • Liang Yao
Article

DOI: 10.1007/s00464-012-2758-6

Cite this article as:
Jiang, L., Yang, KH., Guan, QL. et al. Surg Endosc (2013) 27: 2466. doi:10.1007/s00464-012-2758-6

Abstract

Background

We carry out a meta-analysis to evaluate the effectiveness and safety of laparoscopy-assisted gastrectomy (LAG) versus open gastrectomy for resectable gastric cancer.

Methods

We searched EMBASE, the Cochrane Library, PubMed, Science Citation Index (SCI), Chinese biomedicine literature database to identify randomized controlled trials (RCTs) from their inception to April 2012. Meta-analyses were performed using RevMan 5.0 software. It was in line with the preferred reporting items for systematic reviews and meta-analyses statement. The quality of evidence was assessed by GRADEpro 3.6.

Results

Eight RCTs totaling 784 patients were analyzed. Compared with open gastrectomy group, no significant differences were found in postoperative mortality (OR = 1.49; 95 % CI 0.29–7.79), anastomotic leakage (OR = 1.02; 95 % CI 0.24–4.27) , overall mean number of harvested lymph nodes [weighed mean difference (MD) = −3.17; 95 % CI −6.39 to 0.05]; the overall postoperative complication morbidity (OR = 0.54; 95 % CI 0.36–0.82), estimated blood loss (MD = −107.23; 95 % CI −148.56 to −65.89,) frequency of analgesic administration (MD = −1.69; 95 % CI −2.18 to −1.21, P < 0.00001), incidence of pulmonary complications (OR = 0.43, 95 % CI 0.20–0.93, P = 0.03) were significantly less in LAG group; LAG had shorter time to start first flatus (MD = −0.23; 95 % CI −0.41 to −0.05) and decreased hospital stay (MD = −1.72; 95 % CI −3.40 to 0.04), but, LAG still had longer operation time (MD = 76.70; 95 % CI 51.54–101.87).

Conclusions

On the basis of this meta-analysis we conclude that although LAG was still a time-consuming and technically dependent procedure, it has the advantage of better short-term outcome. Long term survival data from other studies are urgently needed to estimate the survival benefit of this technique.

Keywords

AbdominalCancerGISurgical

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Lei Jiang
    • 1
    • 2
  • Ke-Hu Yang
    • 1
    • 2
  • Quan-Lin Guan
    • 2
  • Nong Cao
    • 2
    • 1
  • Yan Chen
    • 2
  • Peng Zhao
    • 2
  • Yao-Long Chen
    • 1
  • Liang Yao
    • 1
    • 2
  1. 1.Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou UniversityLanzhouChina
  2. 2.First Hospital of Lanzhou UniversityLanzhouChina