Laparoscopic versus open distal gastrectomy for gastric cancer: A systematic review and meta-analysis.

Autor: Hakkenbrak NAG; Department of Gastrointestinal Surgery, Amsterdam University Medical Center, Location VU Medical Center, the Netherlands. Electronic address: n.hakkenbrak@amsterdamumc.nl., Jansma EP; Medical Library, Amsterdam University Medical Center, Location VU Medical Center, the Netherlands., van der Wielen N; Department of Gastrointestinal Surgery, Amsterdam University Medical Center, Location VU Medical Center, the Netherlands., van der Peet DL; Department of Gastrointestinal Surgery, Amsterdam University Medical Center, Location VU Medical Center, the Netherlands., Straatman J; Department of Gastrointestinal Surgery, Amsterdam University Medical Center, Location VU Medical Center, the Netherlands; Department of Epidemiology and Biostatistics, Amsterdam University Medical Center, Location VU Medical Center, the Netherlands.
Jazyk: angličtina
Zdroj: Surgery [Surgery] 2022 Jun; Vol. 171 (6), pp. 1552-1561. Date of Electronic Publication: 2022 Jan 31.
DOI: 10.1016/j.surg.2021.11.035
Abstrakt: Objective: Laparoscopic distal gastrectomy (LDG) with adequate lymph node dissection for gastric cancer is increasingly being applied worldwide. Several randomized trials have been conducted regarding this surgical approach. The aim of this meta-analysis is to present an updated overview comparing laparoscopic distal gastrectomy and open distal gastrectomy (ODG) with regard to short-term results, long-term follow-up, and oncological outcomes.
Methods: An extensive search was conducted using the Medline, Embase, and Cochrane databases, including randomized clinical trials comparing LDG and open distal gastrectomy. Studies were assessed regarding outcomes for operative results, postoperative recovery, complications, mortality, adequacy of resection, and long-term survival.
Results: In total, 2,347 articles were identified, and 22 randomized clinical trials were selected for analysis. Operative results showed significantly less blood loss and a longer operative time for LDG. Patients after LDG showed a faster recovery of bowel function, shorter hospitalization, and fewer complications, while mortality rates did not differ. Lymph node yield and resection margins were similar in both groups. Results regarding survival could not be analyzed due to a great diversity in follow-up duration.
Conclusion: Laparoscopic distal gastrectomy shows favorable outcomes, such as less perioperative blood loss, faster patient recovery, and fewer complications. Moreover, LDG is oncologically adequate regarding lymph node yield, adequacy of resection, and survival.
(Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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