Systematic review of feasibility and safety of laparoscopic gastrectomy for gastric cancer

来源 :中德临床肿瘤学杂志(英文版) | 被引量 : 0次 | 上传用户:februaryliao
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Objective: The purpose of the present study was to retrospectively and systematically evaluate the feasibility and safety of laparoscopic gastrectomy for gastric cancer.Methods: Research of prospective, randomized, controlled studies addressing laparoscopic gastrectomy versus open gastrectomy was screened through computer-based online system.Meta-analysis of acquired data was performed.The inverse variance method was used to test the significance of continuous data, while the Mantel-Haenszel method was used for dichotomous data.The chi-square test was used for evaluation of data heterogeneity.Homogenous data were calculated using the fixed effect model, and heterogeneous data were calculated using freedom model.Statistical data were expressed as 95% confidence interval (95% CI).Funnel plot was used for sensitivity analysis to show potential publication bias.Results: Five papers met the inclusion criteria, 164 cases underwent laparoscopic gastrectomy and 162 cases received open gastrectomy.Meta-analysis revealed that laparoscopic gastrectomy took longer operating time and removed fewer lymph nodes than open gastrectomy (both P < 0.01), but for early-stage gastric cancer, laparoscopic gastrectomy was superior to open gastrectomy in terms of blood loss and hospital stay (P < 0.01).But there were no significant differences in terms of time to resumption of oral intake, postoperative complications, postoperative morbidity rate, and tumor recurrence.Sensitive analysis demonstrated that publication bias existed in all indices to different extents with the exception of lymph node.Subgroup analysis showed that for D1 lymph node dissection, laparoscopic gastrectomy took significantly reduced blood loss than open gastrectomy.Conclusion: All these findings indicate that laparoscopic gastrectomy for early stage gastric cancer is feasible and safe.
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