title: Long-term clinical outcomes of laparoscopy-assisted distal gastrectomy versus open distal gastrectomy for early gastric cancer: A comprehensive systematic review and meta-analysis of randomized control trials.
abstract: The objective of this study was to compare long-term surgical outcomes and complications of laparoscopy-assisted distal gastrectomy (LADG) with open distal gastrectomy (ODG) for the treatment of early gastric cancer (EGC) based on a review of available randomized controlled trials (RCTs) evaluated using the Cochrane methodology.RCTs comparing LADG and ODG were identified by a systematic literature search in PubMed, Cochrane Library, MEDLINE, EMBASE, Scopus, and the China Knowledge Resource Integrated Database, for papers published from January 1, 2003 to July 30, 2015. Meta-analyses were performed to compare the long-term clinical outcomes.Our systematic literature search identified 8 eligible RCTs including 732 patients (374 LADGs and 358 ODGs), with low overall risk of bias. Long-term mortality and relapse rate were comparable for both techniques. The long-term complication rate was 8.47% in LADG groups and 13.62% in the ODG group, indicating that LADG was associated with lower risk for long-term complications (RR = 0.63; 95%CI = 0.39-1.00; P = 0.03).In the treatment of EGC, LADG lowered the rate of long- and short-term complications and promoted earlier recovery, with comparable oncological outcomes to ODG.
authors.affiliation: Department of General Surgery and Laboratory of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine Institute of Biliary Tract Diseases Research, Shanghai Jiao Tong University School of Medicine Department of Nutrition, Zhongshan hospital, Affiliated to Fudan University Center of Clinical Epidemiology and Evidence-based Medicine, Fudan University, Shanghai, China Rush Alzheimer's Disease Center Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Wei
authors.initials: W
authors.lastname: Lu
authors.forename: Jian
authors.initials: J
authors.lastname: Gao
authors.forename: Jingyun
authors.initials: J
authors.lastname: Yang
authors.forename: Yijian
authors.initials: Y
authors.lastname: Zhang
authors.forename: Wenjie
authors.initials: W
authors.lastname: Lv
authors.forename: Jiasheng
authors.initials: J
authors.lastname: Mu
authors.forename: Ping
authors.initials: P
authors.lastname: Dong
authors.forename: Yingbin
authors.initials: Y
authors.lastname: Liu
mesh_terms: D005743:Gastrectomy / Q000379:methods*; D005763:Gastroenterostomy; D006801:Humans; D010535:Laparoscopy; D009367:Neoplasm Staging; D016032:Randomized Controlled Trials as Topic; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome