TY - JOUR
T1 - Laparoscopic versus open distal gastrectomy for gastric cancer
T2 - A systematic review and meta-analysis
AU - Hakkenbrak, Nadia A. G.
AU - Jansma, Elise P.
AU - van der Wielen, N.
AU - van der Peet, Donald L.
AU - Straatman, Jennifer
N1 - Publisher Copyright:
© 2021 The Author(s)
PY - 2022/6
Y1 - 2022/6
N2 - Objective: Laparoscopic distal gastrectomy (LDG) with adequate lymph node dissection for gastric cancer is increasingly being applied worldwide. Several randomized trials have been conducted regarding this surgical approach. The aim of this meta-analysis is to present an updated overview comparing laparoscopic distal gastrectomy and open distal gastrectomy (ODG) with regard to short-term results, long-term follow-up, and oncological outcomes. Methods: An extensive search was conducted using the Medline, Embase, and Cochrane databases, including randomized clinical trials comparing LDG and open distal gastrectomy. Studies were assessed regarding outcomes for operative results, postoperative recovery, complications, mortality, adequacy of resection, and long-term survival. Results: In total, 2,347 articles were identified, and 22 randomized clinical trials were selected for analysis. Operative results showed significantly less blood loss and a longer operative time for LDG. Patients after LDG showed a faster recovery of bowel function, shorter hospitalization, and fewer complications, while mortality rates did not differ. Lymph node yield and resection margins were similar in both groups. Results regarding survival could not be analyzed due to a great diversity in follow-up duration. Conclusion: Laparoscopic distal gastrectomy shows favorable outcomes, such as less perioperative blood loss, faster patient recovery, and fewer complications. Moreover, LDG is oncologically adequate regarding lymph node yield, adequacy of resection, and survival.
AB - Objective: Laparoscopic distal gastrectomy (LDG) with adequate lymph node dissection for gastric cancer is increasingly being applied worldwide. Several randomized trials have been conducted regarding this surgical approach. The aim of this meta-analysis is to present an updated overview comparing laparoscopic distal gastrectomy and open distal gastrectomy (ODG) with regard to short-term results, long-term follow-up, and oncological outcomes. Methods: An extensive search was conducted using the Medline, Embase, and Cochrane databases, including randomized clinical trials comparing LDG and open distal gastrectomy. Studies were assessed regarding outcomes for operative results, postoperative recovery, complications, mortality, adequacy of resection, and long-term survival. Results: In total, 2,347 articles were identified, and 22 randomized clinical trials were selected for analysis. Operative results showed significantly less blood loss and a longer operative time for LDG. Patients after LDG showed a faster recovery of bowel function, shorter hospitalization, and fewer complications, while mortality rates did not differ. Lymph node yield and resection margins were similar in both groups. Results regarding survival could not be analyzed due to a great diversity in follow-up duration. Conclusion: Laparoscopic distal gastrectomy shows favorable outcomes, such as less perioperative blood loss, faster patient recovery, and fewer complications. Moreover, LDG is oncologically adequate regarding lymph node yield, adequacy of resection, and survival.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85123724860&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/35101328
U2 - 10.1016/j.surg.2021.11.035
DO - 10.1016/j.surg.2021.11.035
M3 - Review article
C2 - 35101328
SN - 0039-6060
VL - 171
SP - 1552
EP - 1561
JO - Surgery
JF - Surgery
IS - 6
ER -