Laparoscopic versus open gastrectomy for advanced gastric cancer: A meta-analysis based on high-quality retrospective studies and clinical randomized trials - 03/12/18
, Chaogang Fan c, Guoli Li cBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
| pages | 14 |
| Iconographies | 6 |
| Vidéos | 0 |
| Autres | 0 |
Highlights |
• | Fifteen studies recently published were selected in this meta-analysis, including four randomized clinical trials and eleven retrospective studies. Of them, seven articles were published in recent three years. |
• | The present study not only showed that laparoscopy gastrectomy can be used as an alternative to open gastrectomy for patients with advanced gastric cancer but also revealed that laparoscopy gastrectomy offers advantages of quicker postoperative recovery and comparable safety and efficacy. |
• | Although the longer operative time was observed in laparoscopy gastrectomy, the learning curve can be overcome by performing more than 50 laparoscopic gastrectomy procedures to increase systemic lymphadenectomy experience. |
Summary |
Background |
Additional studies comparing laparoscopic gastrectomy (LG) with open gastrectomy (OG) have been published, and the meta-analysis of this subject should be improved.
Methods |
Randomized controlled trials and high-quality retrospective studies, which compared LG and OG for advanced gastric cancer (AGC) treatment and were published in English and Chinese between January 2000 and February 2017, were selected through PubMed, EMBASE, and the Cochrane Library database by two reviewers independently. The Jadad Composite Scale and the Newcastle–Ottawa scale were used to evaluate the quality and risk of bias for all included studies. Operative outcomes, postoperative outcomes, postoperative morbidity, harvested lymph nodes and 5-year overall survival (OS) were considered as primary endpoints and were compared.
Results |
Fifteen studies including a total of 9337 cases (5000 in LG and 4337 in OG) were enrolled. LG showed longer operative time, less intraoperative blood loss, and quicker recovery after operations. Based on the subgroup analysis of the sample size, however, there was no difference in operative time between LG and OG. The number of harvested lymph nodes, 5-year OS, and postoperative morbidity were similar.
Conclusion |
LG can be performed as an alternative to OG for AGC, with quicker postoperative recovery and comparable safety and efficacy.
Le texte complet de cet article est disponible en PDF.Keywords : Laparoscopic gastrectomy, Open gastrectomy, Advanced gastric cancer, Meta-analysis
Plan
Vol 42 - N° 6
P. 577-590 - décembre 2018 Retour au numéro
Article précédent
- Low urine pH is a risk for non-alcoholic fatty liver disease: A population-based longitudinal study
- Takuro Okamura, Yoshitaka Hashimoto, Masahide Hamaguchi, Akihiro Obora, Takao Kojima, Michiaki Fukui
- Adherence to quality indicators in endoscopic surveillance of Barrett's esophagus and correlation to dysplasia detection rates
- Andrew Antony, Charles Pohanka, Susan Keogh, Robert Klein, Mohammad Alshelleh, Calvin Lee, Arvind J. Trindade
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’achat d’article à l’unité est indisponible à l’heure actuelle.
Déjà abonné à cette revue ?