Meta-analysis of laparoscopy-assisted distal gastrectomy with D2 lymph node dissection for gastric cancer
Meta-analysis of laparoscopy-assisted distal gastrectomy with D2 lymph node dissection for gastric cancer
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DOI：
10.1002/jso.22098
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发表时间：
2012-03-01
影响因子：
2.5
通讯作者：
Tang, Jing
中科院分区：
文献类型：
--
作者：
Ding, Jie;Liao, Guo-Qing;Tang, Jing
目的：评价腹腔镜辅助下远端胃切除联合D2切除治疗胃癌的价值。方法：收集近15年来应用腹腔镜辅助下远端胃切除(LADG)和开腹远端胃切除(ODG)联合D2切除治疗胃癌的研究。使用固定效应和随机效应模型对LADG和ODG感兴趣的数据进行Meta分析。结果：我们分析了8项研究，包括1,065名患者。LADG组和ODG组在手术时间、出血量、首次排气时间、首次进食时间、术后住院时间、术后并发症等方面有显著差异。与ODG组相比，LADG组出血量少，并发症少，胃肠功能恢复时间短，住院时间短，手术时间长。结论：LADG加D2清扫术与ODG相比，具有创伤小、恢复快、并发症少等优点，可达到与ODG相同的根治程度和近期预后。缺点是手术时间稍长，远期预后尚不清楚。J·奥科尔外科医生。2012年；105：297-303。(C)2011年威利期刊公司。
Background To assess the value of laparoscopy-assisted distal gastrectomy with D2 dissection for treatment of gastric cancer.Methods: We collected studies that have compared laparoscopy-assisted distal gastrectomy (LADG) and open distal gastrectomy (ODG) with D2 dissection for treatment of gastric cancer in the past 15 years. Data of interest for LADG and ODG were subjected to meta-analysis using a fixed-effect and random-effect model.Results: We analyzed 8 studies that included 1,065 patients. There were significant differences in operating time, blood loss, time to first flatus and first eating, postoperative hospital stay, and postoperative complications between the LADG and ODG groups. Compared with the ODG group, blood loss and complications in the LADG group decreased, time to recovery of gastrointestinal function and hospitalization period were shorter, but operating time was longer. There were no significant differences in the number of harvested lymph nodes, mortality, and rate of recurrence between the groups.Conclusions: Compared with ODG, LADG with D2 dissection has the advantages of minimal invasion, faster recovery, and fewer complications, and it can achieve the same degree of radicality and short-term prognosis as ODG. The drawbacks are that the operating time is slightly longer and long-term prognosis is not clear. J. Surg. Oncol. 2012;105:297-303. (C) 2011 Wiley Periodicals, Inc.