Laparoscopy-assisted gastrectomy versus open gastrectomy for resectable gastric cancer: an update meta-analysis based on randomized controlled trials
Laparoscopy-assisted gastrectomy versus open gastrectomy for resectable gastric cancer: an update meta-analysis based on randomized controlled trials
复制标题
DOI：
10.1007/s00464-012-2758-6
复制
发表时间：
2013-07-01
影响因子：
3.1
通讯作者：
Yao, Liang
中科院分区：
文献类型：
--
作者：
Jiang, Lei;Yang, Ke-Hu;Yao, Liang
我们进行了一项荟萃分析，以评估腹腔镜辅助胃切除术（LAG）与开腹胃切除术治疗可切除胃癌的有效性和安全性。我们检索了 EMBASE、Cochrane 图书馆、PubMed、科学引文索引（SCI）、中国生物医学文献数据库，以识别从开始到 2012 年 4 月的随机对照试验（RCT）。使用 RevMan 5.0 软件进行荟萃分析。它符合系统评价和荟萃分析声明的首选报告项目。证据质量通过 GRADEpro 3.6 进行评估。分析了 8 项随机对照试验，共计 784 名患者。与开腹胃切除组相比，术后死亡率（OR = 1.49；95 % CI 0.29-7.79）、吻合口漏（OR = 1.02；95 % CI 0.24-4.27）、总体平均淋巴结数目[加权平均差（MD）= -3.17； 95% CI -6.39 至 0.05]；术后总体并发症发生率（OR = 0.54；95 % CI 0.36-0.82）、估计失血量（MD = -107.23；95 % CI -148.56 至 -65.89）、镇痛给药频率（MD = -1.69；95 % CI -2.18 至 -1.21，P < LAG 组肺部并发症发生率（OR = 0.43，95% CI 0.20-0.93，P = 0.03）明显较低； LAG 首次排气的时间较短 (MD = -0.23; 95 % CI -0.41 至 -0.05)，并缩短了住院时间 (MD = -1.72; 95 % CI -3.40 至 0.04)，但 LAG 的手术时间仍然较长 (MD = 76.70; 95 % CI 51.54-101.87)。基于此荟萃分析我们的结论是，虽然 LAG 仍然是一个耗时且技术依赖的程序，但它具有短期结果更好的优点。迫切需要其他研究的长期生存数据来估计该技术的生存效益。
We carry out a meta-analysis to evaluate the effectiveness and safety of laparoscopy-assisted gastrectomy (LAG) versus open gastrectomy for resectable gastric cancer.We searched EMBASE, the Cochrane Library, PubMed, Science Citation Index (SCI), Chinese biomedicine literature database to identify randomized controlled trials (RCTs) from their inception to April 2012. Meta-analyses were performed using RevMan 5.0 software. It was in line with the preferred reporting items for systematic reviews and meta-analyses statement. The quality of evidence was assessed by GRADEpro 3.6.Eight RCTs totaling 784 patients were analyzed. Compared with open gastrectomy group, no significant differences were found in postoperative mortality (OR = 1.49; 95 % CI 0.29-7.79), anastomotic leakage (OR = 1.02; 95 % CI 0.24-4.27) , overall mean number of harvested lymph nodes [weighed mean difference (MD) = -3.17; 95 % CI -6.39 to 0.05]; the overall postoperative complication morbidity (OR = 0.54; 95 % CI 0.36-0.82), estimated blood loss (MD = -107.23; 95 % CI -148.56 to -65.89,) frequency of analgesic administration (MD = -1.69; 95 % CI -2.18 to -1.21, P < 0.00001), incidence of pulmonary complications (OR = 0.43, 95 % CI 0.20-0.93, P = 0.03) were significantly less in LAG group; LAG had shorter time to start first flatus (MD = -0.23; 95 % CI -0.41 to -0.05) and decreased hospital stay (MD = -1.72; 95 % CI -3.40 to 0.04), but, LAG still had longer operation time (MD = 76.70; 95 % CI 51.54-101.87).On the basis of this meta-analysis we conclude that although LAG was still a time-consuming and technically dependent procedure, it has the advantage of better short-term outcome. Long term survival data from other studies are urgently needed to estimate the survival benefit of this technique.