Laparoscopic D2 distal gastrectomy versus conventional open surgery for advanced gastric cancer: The safety analysis from a multicenter prospective randomized controlled trial in China (CLASS-01 Trial).

Hu, Yanfeng; Huang, Chang‐Ming; Sun, Yihong; Su, Xiangqian; Li, Ziyu; Xue, Yingwei; Hu, Jian‐Kun; He, Xianli; Tao, Kaixiong; Zhao, Gang; Suo, Jian; H, Wei; Hu, Weiguo; Ying, Mingang; Du, Xiaosheng; Chen, Pingyan; Li, Guoxin

doi:10.1200/jco.2015.33.15_suppl.4032

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“…Two studies did not provide any data for the control group and were excluded [62,63]. Eight trials were excluded because they thought to be published in the same institution by the same team [24,25,[64][65][66][67][68][69]. Seventeen studies were eventually included in the current meta-analysis [18][19][20][21][22][23][70][71][72][73][74][75][76][77][78][79][80].…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

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Laparoscopy-Assisted Versus Open Gastrectomy for Gastric Cancer: A Comprehensive Systematic Review and Meta-Analysis Based on Randomized Controlled Trials

Salih

2019

CTOIJ

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Background: This meta-analysis was conducted to evaluate the safety and effectiveness of laparoscopy-assisted gastrectomy compared to conventional surgery for gastric cancer. Previous meta-analyses lacked statistical power to reach a definitive conclusion.Methods: Randomized controlled trials (RCTs) comparing LAG with OG for gastric cancer published until May 2019 were retrieved using Mendeley, PubMed, EMBASE, the Cochrane Library and Google Scholar databases. The Cochrane Risk of Bias tool was used to assess the methodological quality of the included RCTs. Operative outcomes, post-operative outcomes and oncological outcomes were analyzed using random effects model. Statistical analysis was performed using Review Manager 5.3. The quality of evidence was assessed using the Grading of Recommendation Assessment, Development and Evaluation guidelines (GRADE) guidelines.Results: Seventeen trials totaling 5198 participants were included in this meta-analysis. In comparison with open surgery, laparoscopy-assisted gastrectomy showed less intra-operative blood loss (MD -73.55, 95% CI -98.17 to -48.93,P < 0.00001), shorter time to first ambulation (MD -0.49, 95% CI -0.89 to -0.09, P < 0.02), flatus (MD -1.14, 95% CI -1.68 to -0.60, P < 0.0001) and oral intake (MD -0.59, 95% CI -1.03 to -0.14, P < 0.01), shorter hospitalization (MD -1.15, 95% CI -1.90 to -0.40, P < 0.00001), lower overall post-operative morbidity (OR 0.80, 95% CI 0.65 to 0.99), P = 0.04), the operative time was significantly longer for the laparoscopic approach group (MD 67.90, 95% CI 54.51 to 81.30, P < 0.00001). No significant difference was found between the LAG and OG regarding mortality rates and incidence of reoperation, which supports the safety of LAG. The number of harvested lymph nodes and tumor recurrence/metastasis did not significantly differ between the two groups, indicating oncological equivalence of both approaches. Conclusion:Although LAG is a technically demanding and time-consuming procedure, it can be used as an acceptable and safe alternative to OG, with better short-term results.

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Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…Seventeen studies were eventually included in the current meta-analysis [18][19][20][21][22][23][70][71][72][73][74][75][76][77][78][79][80]. Necessary information was still obtained from the eight excluded studies [24,25,[64][65][66][67][68][69]. A flow diagram of the trial selection process is shown in (Figure 1).…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Laparoscopy-Assisted Versus Open Gastrectomy for Gastric Cancer: A Comprehensive Systematic Review and Meta-Analysis Based on Randomized Controlled Trials

Salih

2019

CTOIJ

View full text Add to dashboard Cite

show abstract

Laparoscopic D2 distal gastrectomy versus conventional open surgery for advanced gastric cancer: The safety analysis from a multicenter prospective randomized controlled trial in China (CLASS-01 Trial).

Cited by 1 publication

References 0 publications

Laparoscopy-Assisted Versus Open Gastrectomy for Gastric Cancer: A Comprehensive Systematic Review and Meta-Analysis Based on Randomized Controlled Trials

Laparoscopy-Assisted Versus Open Gastrectomy for Gastric Cancer: A Comprehensive Systematic Review and Meta-Analysis Based on Randomized Controlled Trials

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