Meta-analysis of laparoscopic and open distal gastrectomy for gastric carcinoma

Abstract

ABSTRACT:Objectives: The aim was to conduct a meta-analysis of the randomized evidence to determine the relative merits of laparoscopic assisted (LADG) and open (ODG) distal gastrectomy for proven gastric cancer. However, for commencement of oral intake, duration of hospital stay and complication rate, the trend was in favour of LADG. Data sources and review methods: Conclusion:LADG was associated with a significantly reduced rate of intraoperative blood loss, at the expense of significantly longer operating time and significantly reduced lymph node retrieval compared to its open counterpart.Mortality and tumour recurrence rates were similar between the two groups.

Improving the outcomes in gastric cancer surgery

“…Also, longer operation time and lower number of harvested lymph nodes was reported for laparoscopic gastrectomy. Several other reviews and meta-analyses have been published on this subject since (Table 3) [59][60][61][62][63] . The general conclusion of these studies is that laparoscopic approach offers improved recovery after surgery at no compromise of morbidity and mortality.…”

What technique is suitable for laparoscopic suprapancreatic lymph node dissection?

“…There are four randomized controlled trials (RCTs) and several retrospective studies of the outcomes of LADG. The meta-analysis by Memon et al shows that the number of dissected lymph nodes in LADG is lower than that in open gastrectomy [3]. Indeed, Miura et al show in a retrospective study that the number of dissected suprapancreatic lymph nodes (No.…”

Ongoing clinical studies of minimally invasive surgery for gastric cancer in Japan

“…Although these data may be considered preliminary, they appear to indicate that LAG for EGC yields good short-and long-term oncologic outcomes. In addition, morbidity and mortality rates following LADG are identical to or less than those observed following open distal gastrectomy (ODG) as per the published small randomized clinical trials (RCTs) (14)(15)(16)(17).…”

“…Small-scale randomized controlled trials, a non-randomized study and retrospective studies have demonstrated that LAG has superior shortterm and comparable long-term outcomes to open gastrectomy (11)(12)(13)(14)(15)(16)(17). As a result, the guidelines were revised based on the latest evidence and trends of cancer treatments in 2014.…”