Long-term clinical outcomes of laparoscopy-assisted distal gastrectomy versus open distal gastrectomy for early gastric cancer A comprehensive systematic review and meta-analysis of randomized control trials

被引:27
作者
Lu, Wei [1 ,2 ,3 ]
Gao, Jian [4 ,5 ]
Yang, Jingyun [6 ,7 ]
Zhang, Yijian [1 ,2 ,3 ]
Lv, Wenjie [1 ,2 ]
Mu, Jiasheng [1 ,2 ]
Dong, Ping [1 ,2 ]
Liu, Yingbin [1 ,2 ,3 ]
机构
[1] Shanghai Jiao Tong Univ, Sch Med, Xinhua Hosp, Dept Gen Surg, 1665 Kongjiang Rd,Room 513,Sci & Technol Bldg, Shanghai 200092, Peoples R China
[2] Shanghai Jiao Tong Univ, Sch Med, Xinhua Hosp, Lab Gen Surg, 1665 Kongjiang Rd,Room 513,Sci & Technol Bldg, Shanghai 200092, Peoples R China
[3] Shanghai Jiao Tong Univ, Sch Med, Inst Biliary Tract Dis Res, Shanghai, Peoples R China
[4] Fudan Univ, Zhongshan Hosp, Dept Nutr, Shanghai, Peoples R China
[5] Fudan Univ, Ctr Clin Epidemiol & Evidence Based Med, Shanghai, Peoples R China
[6] Rush Univ, Med Ctr, Rush Alzheimers Dis Ctr, Chicago, IL 60612 USA
[7] Rush Univ, Med Ctr, Dept Neurol Sci, Chicago, IL 60612 USA
基金
中国国家自然科学基金; 中国博士后科学基金;
关键词
clinical outcomes; early gastric cancer; laparoscopy-assisted distal gastrectomy; meta-analysis; open distal gastrectomy; COMPARING OPEN; GUIDELINES; MANAGEMENT; SURGERY; QUALITY; GRADE; BIAS;
D O I
10.1097/MD.0000000000003986
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The objective of this study was to compare long-term surgical outcomes and complications of laparoscopy-assisted distal gastrectomy (LADG) with open distal gastrectomy (ODG) for the treatment of early gastric cancer (EGC) based on a review of available randomized controlled trials (RCTs) evaluated using the Cochrane methodology. RCTs comparing LADG and ODG were identified by a systematic literature search in PubMed, Cochrane Library, MEDLINE, EMBASE, Scopus, and the China Knowledge Resource Integrated Database, for papers published from January 1, 2003 to July 30, 2015. Meta-analyses were performed to compare the long-term clinical outcomes. Our systematic literature search identified 8 eligible RCTs including 732 patients (374 LADGs and 358 ODGs), with low overall risk of bias. Long-term mortality and relapse rate were comparable for both techniques. The long-term complication rate was 8.47% in LADG groups and 13.62% in the ODG group, indicating that LADG was associated with lower risk for long-term complications (RR = 0.63; 95% CI = 0.39-1.00; P = 0.03). In the treatment of EGC, LADG lowered the rate of long-and short-term complications and promoted earlier recovery, with comparable oncological outcomes to ODG.
引用
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页数:9
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