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Meta-Analysis
. 2014 Nov 14;20(42):15867-78.
doi: 10.3748/wjg.v20.i42.15867.

Totally laparoscopic gastrectomy for gastric cancer: a systematic review and meta-analysis of outcomes compared with open surgery

Ke Chen  1 , Yu Pan  1 , Jia-Qin Cai  1 , Xiao-Wu Xu  1 , Di Wu  1 , Yi-Ping Mou  1
Affiliations
Meta-Analysis

Totally laparoscopic gastrectomy for gastric cancer: a systematic review and meta-analysis of outcomes compared with open surgery

Ke Chen et al. World J Gastroenterol. .

Abstract

Aim: To systematically review the surgical outcomes of totally laparoscopic gastrectomy (TLG) vs open gastrectomy (OG) for gastric cancer.

Methods: A systematic search of PubMed, Embase, Cochrane Library, and Web of Science was conducted. All original studies comparing TLG with OG were included for critical appraisal. Data synthesis and statistical analysis were carried out using RevMan 5.1 software.

Results: One RCT and 13 observational studies involving 1532 patients were included (721 TLG and 811 OG). TLG was associated with longer operation time [weighted mean difference (WMD) = 58.04 min, 95%CI: 37.77-78.32, P < 0.001], less blood loss [WMD = -167.57 min, 95%CI: -208.79-(-126.34), P < 0.001], shorter hospital stay [WMD = -3.75 d, 95%CI: -4.88-(-2.63), P < 0.001] and fewer postoperative complications (RR = 0.71, 95%CI: 0.58-0.86, P < 0.001). The number of harvested lymph nodes, surgical margin, mortality and cancer recurrence rate were similar between the two groups.

Conclusion: TLG may be a technically safe, feasible and favorable approach in terms of better cosmesis, less blood loss and faster recovery compared with OG.

Keywords: Gastrectomy; Gastric cancer; Intracorporeal anastomosis; Laparoscopy; Meta-analysis; Survival.

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Figures

Figure 1
Figure 1
Flow chart of literature search strategies. Spelling of search in figure incorrect.
Figure 2
Figure 2
Meta-analysis of the pooled data. A: Operation time; B: Intraoperative blood loss; C: Retrieved lymph nodes; D: Postoperative hospital stay; E: Mortality; F: Overall complications; G: Recurrence.
Figure 3
Figure 3
Funnel plots of the overall postoperative complications.
See this image and copyright information in PMC

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