Meta-analysis of laparoscopy-assisted and open distal gastrectomy for gastric cancer.
BACKGROUND
Laparoscopy-assisted distal gastrectomy (LADG) for gastric cancer is a minimally invasive technique. We performed a meta-analysis of five randomized clinical trials (RCTs) to evaluate and compare the benefits of LADG with those of open distal gastrectomy (ODG).


METHODS
The present meta-analysis was based on the comparison of LADG with ODG for gastric cancer. The following factors were examined: operative time, estimated blood loss, number of harvested lymph nodes, time to resumption of oral intake, duration of hospital stay, frequency of analgesic administration, complications, tumor recurrence, and mortality.


RESULTS
We selected five RCTs to compare LADG with ODG for gastric cancer. A total of 326 patients with gastric cancer were included in this meta-analysis of whom 164 underwent LADG and 162 underwent ODG. There was a significant difference in the volume of intraoperative blood loss, period of hospital stay, frequency of analgesic administration, and rate of complications between LADG and ODG. There was no difference in the resumption of oral intake, rate of tumor recurrence, and mortality. The operative time was significantly longer and the number of harvested lymph nodes was significantly smaller in LADG than in ODG.


CONCLUSIONS
LADG is significantly superior to ODG regarding the volume of blood loss, duration of hospital stay, level of pain, and risk of complications. There was no difference in the resumption of oral intake, rate of tumor recurrence, and mortality. However, LADG was significantly inferior to ODG regarding operative time and also had a smaller number of harvested lymph nodes.
Ohtani
Hiroshi
H
Department of Surgery, Osaka City Sumiyoshi Hospital, and Department of Surgical Oncology, Osaka City University Graduate School of Medicine, osaka, Japan. m5051923@msic.med.osaka-cu.ac.jp
Tamamori
Yutaka
Y
Noguchi
Kozou
K
Azuma
Takashi
T
Fujimoto
Shunsuke
S
Oba
Hiroko
H
Aoki
Tetsuya
T
Minami
Mieko
M
Hirakawa
Kosei
K
D005743:Gastrectomy / Q000379:methods* / Q000401:mortality; D006801:Humans; D010535:Laparoscopy / Q000379:methods* / Q000401:mortality; D007902:Length of Stay / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000401:mortality / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D055502:Secondary Prevention; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*