Journal
MEDICINE
Volume 95, Issue 27, Pages -Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MD.0000000000003986
Keywords
clinical outcomes; early gastric cancer; laparoscopy-assisted distal gastrectomy; meta-analysis; open distal gastrectomy
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Funding
- China National High Technology Research and Development Program (863 Program) [2012AA022606]
- National Natural Science Foundation of China [91440203, 81172026, 81272402, 81301816, 81172029]
- China Postdoctoral Science Foundation [2014M561487]
- Interdisciplinary Program of Shanghai Jiao Tong University [14JCRY05]
- NIH/NIA [R01AG036042]
- Illinois Department of Public Health
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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.
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