Laparoscopic versus open total gastrectomy with D2 dissection for gastric cancer: a meta-analysis
Laparoscopic versus open total gastrectomy with D2 dissection for gastric cancer: a meta-analysis
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腹腔镜与 D2 解剖开腹全胃切除术治疗胃癌的荟萃分析
DOI：
10.1007/s00432-013-1462-9
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发表时间：
2013-08
影响因子：
3.6
通讯作者：
Xu, Zekuan
中科院分区：
文献类型：
--
作者：
Wang, Weizhi;Li, Zheng;Tang, Jie;Wang, Meilin;Wang, Baolin;Xu, Zekuan
ObjectiveTo elucidate the feasibility and safety of laparoscopic total gastrectomy with D2 dissection (LTGD2) for gastric cancer in comparison with open total gastrectomy with D2 dissection (OTGD2).BackgroundMore surgeons have chosen laparoscopic total gastrectomy as an alternative to open total gastrectomy. But no meta-analysis has been performed to evaluate the value of LTGD2.MethodsOriginal articles compared LTGD2 and OTGD2 for gastric cancer, which published in English from January 1990 to March 2013 were searched in PubMed, Embase, and Web of Knowledge by two reviewers independently. Operative time, blood loss, harvested lymph nodes, analgesic medication, first flatus day, postoperative hospital stay, postoperative complications, and hospital mortality were compared using STATA version 10.1.Results8 studies were selected in this analysis. A total of 1,498 patients were included (559 in LTG and 939 in OTG). LTGD2 showed longer operative time (WMD 39.29; 95 % CI 20.52, 58.06;P< 0.001), less blood loss (WMD −157.94; 95 % CI −245.25 −70.62;P< 0.001), fewer analgesic requirements (WMD −2.01; 95 % CI −3.10, −0.93;P< 0.001), earlier passage of flatus (WMD −0.73; 95 % CI −1.19, −0.27;P= 0.002), earlier hospital discharge (WMD −2.69; 95 % CI −3.42, −1.97;P< 0.001), and reduced postoperative morbidity (RR 0.70; 95 % CI 0.50, 0.98;P= 0.035). The number of harvested lymph nodes (WMD 0.27; 95 % CI −1.43, 1.98;P= 0.752) and hospital mortality rate (RR 0.57; 95 % CI 0.11, 3.09;P= 0.513) were similar.ConclusionLTGD2 was associated with less blood loss, less postoperative pain, quicker bowel function recovery, shorter hospital stay, and reduced postoperative morbidity, at the expense of longer operative time. No statistical differences were observed in lymph node dissection, and hospital mortality, which indicated the similar ability of lymph nodes clearance and short-term outcomes with OTGD2. A positive trend was indicated toward LTGD2. So we encourage the experienced surgeons to achieve LTGD2 instead of OTGD2. Whereas, due to non-randomized control trails and lack of long-term outcomes, more studies are required.
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影响因子：
2.5
作者：
T. Suto;W. Habano;T. Sugai;N. Uesugi;S. Kanno;K. Saito;Shin‐ichi Nakamura
通讯作者：
T. Suto;W. Habano;T. Sugai;N. Uesugi;S. Kanno;K. Saito;Shin‐ichi Nakamura
影响因子：
6.1
作者：
H. Qin;Chaohong Lin
通讯作者：
H. Qin;Chaohong Lin
影响因子：
2.9
作者：
C. W. Wu;M. Hsieh;S. Tsay;W. Lui;F. P'eng
通讯作者：
C. W. Wu;M. Hsieh;S. Tsay;W. Lui;F. P'eng
DOI：
10.1016/0021-9681(79)90031-6
发表时间：
1979
期刊：
Journal of Chronic Diseases
影响因子：
--
作者：
R. Horwitz
通讯作者：
R. Horwitz
影响因子：
8.8
作者：
de Manzoni, G;Verlato, G;Roviello, F;Morgagni, P;Di Leo, A;Saragoni, L;Marrelli, D;Kurihara, H;Pasini, F
通讯作者：
Pasini, F