Meta-analysis of randomized controlled trials on laparoscopic gastrectomy vs. open gastrectomy for distal gastric cancer

Abstract

Background/aims: To evaluate the safety and practicability of laparoscopic gastrectomy (LG) by comparing the short-term and long-term outcomes of LG and open gastrectomy (OG) for gastric cancer.

Methodology: According to the criterion, randomized clinical trials (RCTs) were searched in MEDLINE, EMBASE, CNKI (in Chinese), WANFANG DATA (in Chinese), and Cochrane Controlled Trials Register from January 2000 to January 2012. The RCTs were prepared in accordance with the quality of reporting of meta-analyses statement. Intraoperative and early postoperative parameters, as well as long-term tumor recurrence were analyzed. Random effect meta-analyses were performed using odds ratios (ORs) and weighted mean differences (WMDs).

Results: Up to 8 RCTs with 782 patients were enrolled in the present meta-analysis (402 patients underwent LG (LG group) and 380 underwent OG (OG group)). The LG group had shorter wound lengths, less blood loss, more rapid bowel function recovery: first flatus and first food intake, lower overall complication rate and shorter hospital stay, whereas the LG group had longer operation times and less harvested lymph nodes. The tumor recurrence between the two groups had no significant difference.

Conclusions: Considering its lower morbidity and enhanced postoperative recovery, LG is a safe technical alternative to OG for distal gastric cancer.