Laparoscopic versus Open Surgery for Gastric Cancer in Western Countries: A Systematic Review and Meta-Analysis of Short- and Long-Term Outcomes.
Laparoscopic versus Open Surgery for Gastric Cancer in Western Countries: A Systematic Review and Meta-Analysis of Short- and Long-Term Outcomes.
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DOI：
10.3390/jcm11133590
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发表时间：
2022-06-22
影响因子：
3.9
通讯作者：
Costa G
中科院分区：
文献类型：
--
作者：
Garbarino GM;Laracca GG;Lucarini A;Piccolino G;Mercantini P;Costa A;Tonini G;Canali G;Muttillo EM;Costa G
背景。腹腔镜方法治疗胃癌的优势已经在东方国家得到证实。本综述和荟萃分析旨在合并所有比较腹腔镜（LG）和开放式胃切除术（OG）的西方研究，以提供汇总结果和更高水平的证据。方法。在MEDLINE（PubMed）、Embase、WebOfScience和Scopus中进行系统的文献检索，比较1980 - 2021年西方中心腹腔镜与开放式胃切除术的研究。结果。在筛选355篇文章后，在西部中心纳入34篇文章，共24,098例接受LG（5445例）或OG（18,653例）的患者。打开胃切除术相比,腹腔镜胃切除术有大大延长手术时间(大规模杀伤性武器= 47.46分钟;95% CI = 31.83 - -63.09; p < 0.001),低失血(大规模杀伤性武器=−129.32毫升;95% CI =−188.11−70.53;p < 0.0001),低镇痛需求(大规模杀伤性武器=−1.824天;95%置信区间CI =−2.314−1.334;p < 0.0001),更快的时间先口服摄入(大规模杀伤性武器=−1.501天;95%置信区间CI =−2.571−0.431;p = 0.0060),住院时间短(大规模杀伤性武器=−2.335;95%可信区间3.061 =−−1.609;p < 0.0001)、较低的死亡率（logOR = - 0.261； 95%从- 0.446到- 0.076;p = 0.0056）和较好的3年总生存率（logOR = 0.245; 95% CI = 0.016-0.474; p = 0.0360）。腹腔镜胃切除术的术后并发症发生率略有显著差异（logOR = - 0.202; 95% CI = - 0.403至- 0.000,= 0.0499）。两组淋巴结清扫数、术后主要并发症发生率及5年总生存率均无统计学差异。结论。在西方中心，腹腔镜胃切除术与开放入路相比具有更好的短期疗效和同等的长期疗效，但需要更多高质量的长期疗效研究。
Background. The advantages of a laparoscopic approach for the treatment of gastric cancer have already been demonstrated in Eastern Countries. This review and meta-analysis aims to merge all the western studies comparing laparoscopic (LG) versus open gastrectomies (OG) to provide pooled results and higher levels of evidence. Methods. A systematic literature search was performed in MEDLINE(PubMed), Embase, WebOfScience and Scopus for studies comparing laparoscopic versus open gastrectomy in western centers from 1980 to 2021. Results. After screening 355 articles, 34 articles with a total of 24,098 patients undergoing LG (5445) or OG (18,653) in western centers were included. Compared to open gastrectomy, laparoscopic gastrectomy has a significantly longer operation time (WMD = 47.46 min; 95% CI = 31.83–63.09; p < 0.001), lower blood loss (WMD = −129.32 mL; 95% CI = −188.11 to −70.53; p < 0.0001), lower analgesic requirement (WMD = −1.824 days; 95% CI = −2.314 to −1.334; p < 0.0001), faster time to first oral intake (WMD = −1.501 days; 95% CI = −2.571 to −0.431; p = 0.0060), shorter hospital stay (WMD = −2.335; 95% CI = −3.061 to −1.609; p < 0.0001), lower mortality (logOR = −0.261; 95% the −0.446 to −0.076; p = 0.0056) and a better 3-year overall survival (logHR 0.245; 95% CI = 0.016–0.474; p = 0.0360). A slight significant difference in favor of laparoscopic gastrectomy was noted for the incidence of postoperative complications (logOR = −0.202; 95% CI = −0.403 to −0.000 the = 0.0499). No statistical difference was noted based on the number of harvested lymph nodes, the rate of major postoperative complication and 5-year overall survival. Conclusions. In Western centers, laparoscopic gastrectomy has better short-term and equivalent long-term outcomes compared with the open approach, but more high-quality studies on long-term outcomes are required.
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影响因子：
4
作者：
Hozo SP;Djulbegovic B;Hozo I
通讯作者：
Hozo I
DOI：
10.1007/s00464-019-07146-6
发表时间：
2019-10-07
影响因子：
3.1
作者：
Abbassi-Ghadi, Nima;Durakovic, Sanja;Preston, Shaun R.
通讯作者：
Preston, Shaun R.
DOI：
10.1007/s004640090089
发表时间：
2001-09-01
影响因子：
3.1
作者：
Adachi, Y;Shiraishi, N;Kitano, S
通讯作者：
Kitano, S
DOI：
10.1089/lap.2020.0023
发表时间：
2020-03-30
影响因子：
1.3
作者：
Ammori, Basil J.;Asmer, Huthaifa;Almasri, Mahmoud
通讯作者：
Almasri, Mahmoud
影响因子：
2.3
作者：
Garbarino, Giovanni Maria;Costa, Gianluca;Masoni, Luigi
通讯作者：
Masoni, Luigi