Short-Term Outcomes Analysis Comparing Open, Laparoscopic, Laparoscopic-Assisted, and Robotic Distal Gastrectomy for Locally Advanced Gastric Cancer: A Randomized Trials Network Analysis

被引:6
作者
Manara, Michele [1 ]
Aiolfi, Alberto [1 ]
Sozzi, Andrea [1 ]
Cali, Matteo [1 ]
Grasso, Federica [1 ]
Rausa, Emanuele [1 ]
Bonitta, Gianluca [1 ]
Bonavina, Luigi [2 ]
Bona, Davide [1 ]
机构
[1] Univ Milan, IRCCS Osped Galeazzi St Ambrogio, Dept Biomed Sci Hlth, Div Gen Surg, Via C Belgioioso 173, I-20157 Milan, Italy
[2] Univ Milan, Dept Biomed Sci Hlth, Div Gen & Foregut Surg, IRCCS Policlin San Donato, Milan, Italy
关键词
distal gastric cancer; open distal gastrectomy; laparoscopic-assisted distal gastrectomy; robotic distal gastrectomy; Bayesian network meta-analysis; LYMPH-NODE DISSECTION; CLINICAL-OUTCOMES; GASTROESOPHAGEAL JUNCTION; SUBTOTAL GASTRECTOMY; METAANALYSIS; SURVIVAL; D2; LYMPHADENECTOMY; SURGERY; QUALITY;
D O I
10.3390/cancers16091620
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background. Minimally invasive surgery for the treatment of locally advanced gastric cancer (AGC) is debated. The aim of this study was to execute a comprehensive assessment of principal surgical treatments for resectable distal gastric cancer. Methods. Systematic review and randomized controlled trials (RCTs) network meta-analysis. Open (Op-DG), laparoscopic-assisted (LapAs-DG), totally laparoscopic (Lap-DG), and robotic distal gastrectomy (Rob-DG) were compared. Pooled effect-size measures were the risk ratio (RR), the weighted mean difference (WMD), and the 95% credible intervals (CrIs). Results. Ten RCTs (3823 patients) were included. Overall, 1012 (26.5%) underwent Lap-DG, 902 (23.6%) LapAs-DG, 1768 (46.2%) Op-DG, and 141 (3.7%) Rob-DG. Anastomotic leak, severe complications (Clavien-Dindo > 3), and in-hospital mortality were comparable. No differences were observed for reoperation rate, pulmonary complications, postoperative bleeding requiring transfusion, surgical-site infection, cardiovascular complications, number of harvested lymph nodes, and tumor-free resection margins. Compared to Op-DG, Lap-DG and LapAs-DG showed a significantly reduced intraoperative blood loss with a trend toward shorter time to first flatus and reduced length of stay. Conclusions. LapAs-DG, Lap-DG, and Rob-DG performed in referral centers by dedicated surgeons have comparable short-term outcomes to Op-DG for locally AGC.
引用
收藏
页数:16
相关论文
共 75 条
  • [1] Long-Term Impact of D2 Lymphadenectomy during Gastrectomy for Cancer: Individual Patient Data Meta-Analysis and Restricted Mean Survival Time Estimation
    Aiolfi, Alberto
    Bona, Davide
    Bonitta, Gianluca
    Lombardo, Francesca
    Manara, Michele
    Sozzi, Andrea
    Schlanger, Diana
    Popa, Calin
    Cavalli, Marta
    Campanelli, Giampiero
    Biondi, Antonio
    Bonavina, Luigi
    [J]. CANCERS, 2024, 16 (02)
  • [2] Staple Line Reinforcement During Laparoscopic Sleeve Gastrectomy: Systematic Review and Network Meta-analysis of Randomized Controlled Trials
    Aiolfi, Alberto
    Gagner, Michel
    Zappa, Marco Antonio
    Lastraioli, Caterina
    Lombardo, Francesca
    Panizzo, Valerio
    Bonitta, Gianluca
    Cavalli, Marta
    Campanelli, Giampiero
    Bona, Davide
    [J]. OBESITY SURGERY, 2022, 32 (05) : 1466 - 1478
  • [3] Systematic review and updated network meta-analysis of randomized controlled trials comparing open, laparoscopic-assisted, and robotic distal gastrectomy for early and locally advanced gastric cancer
    Aiolfi, Alberto
    Lombardo, Francesca
    Matsushima, Kazuhide
    Sozzi, Andrea
    Cavalli, Marta
    Panizzo, Valerio
    Bonitta, Gianluca
    Bona, Davide
    [J]. SURGERY, 2021, 170 (03) : 942 - 951
  • [4] Systematic Review and Bayesian Network Meta-Analysis Comparing Laparoscopic Heller Myotomy, Pneumatic Dilatation, and Peroral Endoscopic Myotomy for Esophageal Achalasia
    Aiolfi, Alberto
    Bona, Davide
    Riva, Carlo Galdino
    Micheletto, Giancarlo
    Rausa, Emanuele
    Campanelli, Giampiero
    Olmo, Giorgia
    Bonitta, Gianluca
    Bonavina, Luigi
    [J]. JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES, 2020, 30 (02): : 147 - 155
  • [5] Oncologic value of laparoscopy-assisted distal gastrectomy for advanced gastric cancer: A systematic review and meta-analysis
    Aurello, Paolo
    Sagnotta, Andrea
    Terrenato, Irene
    Berardi, Giammauro
    Nigri, Giuseppe
    D'Angelo, Francesco
    Ramacciato, Giovanni
    [J]. JOURNAL OF MINIMAL ACCESS SURGERY, 2016, 12 (03) : 199 - 208
  • [6] Laparoscopic Billroth II distal subtotal gastrectomy with gastric stump suspension for gastric malignancies
    BallestaLopez, C
    BastidaVila, X
    Catarci, M
    Mato, R
    Ruggiero, R
    [J]. AMERICAN JOURNAL OF SURGERY, 1996, 171 (02) : 289 - 292
  • [7] Bang YJ, 2010, LANCET, V376, P1302
  • [8] Laparoscopic versus open distal gastrectomy for advanced gastric cancer: A meta-analysis of randomized controlled trials and high- quality nonrandomized comparative studies
    Chen, Xin
    Feng, Xingyu
    Wang, Muqing
    Yao, Xueqing
    [J]. EJSO, 2020, 46 (11): : 1998 - 2010
  • [9] Classification of surgical complications - A new proposal with evaluation in a cohort of 6336 patients and results of a survey
    Dindo, D
    Demartines, N
    Clavien, PA
    [J]. ANNALS OF SURGERY, 2004, 240 (02) : 205 - 213
  • [10] Five-Year Survival Outcomes of Laparoscopy-Assisted vs Open Distal Gastrectomy for Advanced Gastric Cancer The JLSSG0901 Randomized Clinical Trial
    Etoh, Tsuyoshi
    Ohyama, Tetsuji
    Sakuramoto, Shinichi
    Tsuji, Toshikatsu
    Lee, Sang-Woong
    Yoshida, Kazuhiro
    Koeda, Keisuke
    Hiki, Naoki
    Kunisaki, Chikara
    Tokunaga, Masanori
    Otsubo, Dai
    Takagane, Akinori
    Misawa, Kazunari
    Kinoshita, Takahiro
    Cho, Haruhiko
    Doki, Yuichiro
    Nunobe, Souya
    Shiraishi, Norio
    Kitano, Seigo
    [J]. JAMA SURGERY, 2023, 158 (05) : 445 - 454