title: [Systemic review of the safety and efficacy of fast-track surgery combined with laparoscopy in radical gastrectomy for gastric cancer].
abstract: OBJECTIVE
  To conduct a systemic review of the safety and efficacy of fast-track surgery combined with laparoscopy in radical gastrectomy for gastric cancer.
  
  
  METHODS
  The databases, including CNKI, Wangfang, VIP, PubMed, EMBASE and Cochrane Library, were searched to collect randomized controlled trials(RCTs) or clinical controlled trials(CCTs) on the comparison of fast-track surgery combined with laparoscopy versus fast-track surgery or laparoscopy separately used in radical gastrectomy for gastric cancer between January 1994 and December 2012. After data were extracted, meta-analysis was conducted by using RevMan 5.1.0 software.
  
  
  RESULTS
  A total of 3 RCTs and 2 CCTs, involving 524 patients, were included. There were 257 patients in the study group and 267 patients in the control group. Compared with the control group, the study group had earlier first flatus(SMD=-1.29, 95%CI:-2.17 to -0.40, P<0.05), shorter postoperative hospital stay(WMD=-1.72,95%CI:-2.56 to -0.89, P<0.05) and lower postoperative complication rate(OR=0.51, 95%CI:0.31 to 0.84, P<0.05). However, no significant differences were found in operation time, harvested lymph node number, intraoperative blood loss and hospital charge(P>0.05).
  
  
  CONCLUSIONS
  Fast-track surgery combined with laparoscopy in radical gastrectomy for gastric cancer can accelerate postoperative rehabilitation by promoting postoperative bowel function recovery, and decreasing postoperative hospital stay and complication rate.
authors.affiliation: Research Institute of General Surgery, Jinling Hospital, Medicine School of Nanjing University, Nanjing 210002, China. liningnju@163.com.
authors.forename: Shan-jun
authors.initials: SJ
authors.lastname: Tan
authors.forename: Feng
authors.initials: F
authors.lastname: Zhou
authors.forename: Qi-yi
authors.initials: QY
authors.lastname: Chen
authors.forename: Zhi-liang
authors.initials: ZL
authors.lastname: Lin
authors.forename: Ning
authors.initials: N
authors.lastname: Li
mesh_terms: D006801:Humans; D016063:Blood Loss, Surgical; D005743:Gastrectomy; D010535:Laparoscopy; D007902:Length of Stay; D008198:Lymph Nodes; D061646:Operative Time; D011183:Postoperative Complications; D011184:Postoperative Period; D016032:Randomized Controlled Trials as Topic; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery