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Systematic review of laparoscopy-assisted versus open gastrectomy for advanced gastric cancer

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Abstract

Objective

The study compared laparoscopy-assisted gastrectomy (LAG) with open gastrectomy (OG) in the management of advanced gastric cancer (AGC).

Methods

Literature search was performed in the Medline, Embase, and Cochrane Library databases to identify control studies that compared LAG and OG for AGC. A meta-analysis was conducted to examine the surgical safety and oncologic adequacy, using the random-effect model.

Results

Seven eligible studies including 815 patients were analyzed. LAG was associated with less blood loss, less use of analgesics, shorter time of flatus and periods of hospital stay, but longer time of operation. The incidence of most complications was similar between the two groups. However, LAG was associated with a lower rate of pulmonary infection (odds ratio (OR) 0.19; 95% confidence interval (CI) 0.05 to 0.68; P<0.05). No significant differences were noted in terms of the number of harvested lymph nodes (weighted mean difference (WMD) 1.165; 95% CI–2.000 to 4.311; P>0.05), overall mortality (OR 0.65; 95% CI 0.39 to 1.10; P>0.05), cancer-related mortality (OR 0.64; 95% CI 0.32 to 1.25; P>0.05), or recurrence (OR 0.62; 95% CI 0.33 to 1.16; P>0.05).

Conclusions

LAG could be performed safely for AGC with adequate lymphadenectomy and has several short-term advantages compared with conventional OG. No differences were found in long-term outcomes. However, these results should be validated in large randomized controlled studies (RCTs) with sufficient follow-up.

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Authors and Affiliations

  1. Department of Surgery, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China

    Long-yun Ye, Da-ren Liu, Chao Li, Xiao-wen Li, Ling-na Huang, Sheng Ye, Yi-xiong Zheng & Li Chen

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  1. Long-yun Ye
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  2. Da-ren Liu
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  3. Chao Li
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  4. Xiao-wen Li
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  5. Ling-na Huang
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  6. Sheng Ye
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  7. Yi-xiong Zheng
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  8. Li Chen
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Correspondence to Li Chen.

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Project supported by the National Natural Science Foundation of China (No. 81071959) and the Department of Science and Technology of Zhejiang Province (No. 2010C34001), China

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Ye, Ly., Liu, Dr., Li, C. et al. Systematic review of laparoscopy-assisted versus open gastrectomy for advanced gastric cancer. J. Zhejiang Univ. Sci. B 14, 468–478 (2013). https://doi.org/10.1631/jzus.B1200197

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  • DOI: https://doi.org/10.1631/jzus.B1200197

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