Assessment of the efficacy and safety of carbon nanoparticles-guided lymph node dissection in gastric cancer surgery: a systematic review and meta-analysis

Abstract

Background: To investigate the efficacy and safety of lymph nodes (LNs) dissection guided by carbon nanoparticles (CNs) in gastric cancer (GC) surgery.

Materials and methods: We searched electronic databases such as PubMed, Web of Science, Embase, Cochrane Library, and Scopus for relevant articles up to September 2022 and collected all studies comparing the CNs group with blank controls group on the efficacy and safety of LN dissection in gastrectomy. A pooled analysis of the collected data was performed, including the number of retrieved LNs, the staining rate of LNs, the number of metastatic LNs dissection, various intraoperative outcomes, and postoperative complications.

Results: A total of 9 studies including 1770 participants (502 in the CNs group and 1268 in the control group) were included. As compared to the blank control group, the CNs group detected 10.46 more LNs in each patient (WMD = 10.46, 95% CI: 6.63 ~ 14.28, p < 0.00001, I² = 91%), and also significantly more metastatic LNs (WMD = 2.63, 95% CI: 1.43 ~ 3.83, p < 0.0001, I² = 41%). However, there was no significant difference in the rate of metastatic LNs between the CNs and control groups (OR = 1.37, 95% CI: 0.94 ~ 2.00, P = 0.1, I² = 89%). In addition, there was no increase in operative time, intraoperative blood loss, and postoperative complications associated with CNs-guided gastrectomy.

Conclusion: CNs-guided gastrectomy is safe and effective, and can increase the efficiency of LN dissection without increasing the risk of surgery.

Keywords: Carbon nanoparticles; Gastrectomy; Gastric cancer; Lymph node; Meta-analysis.