完全腹腔镜与腹腔镜辅助远端胃癌根治术疗效比较的Meta分析

doi:10.13481/j.1671-587x.20150623

Abstract

Abstract:

Objective To explore the effectiveness and safety of totally laparoscopic distal gastrectomy (TLDG) and laparoscopically assisted distal gastrectomy (LADG) for gastric cancer. Methods The comparative studies of TLDG and LADG published between 2008 and 2014 were searched from PubMed,EMBASE,Chinese Biomedical Literature Database (CBM),China National Knowledge Infrastructure (CNKI).After screening for inclusion,data extraction,and quality assessment,RevMan 5.3 software was used for Meta-analysis. Results Ten studies of 2 212 patients were included in the Meta-analysis,among whom 930 cases underwent TLDG and 1 282 cases underwent LADG.The results of Meta-analysis indicated that compared with LADG,TLDG had the advantages of less blood loss(WMD=-20.70,95%CI:-30.81--10.59,P<0.01),less usage of analgesic(WMD=-0.38,95%CI:-0.74--0.02,P=0.04),more retrieved lymph nodes(WMD=2.98,95%CI:0.71-5.26,P=0.01).However,the Meta-analysis showed no statistically significant differences in the operation time,postoperative time-to-first flatus and oral intake,postoperative hospital stay,length of proximal resection margin,C reaction protein(CRP) level at postoperative day 1,incidence of overall complications and anastomosis-related complications. Conclusion TLDG is safe and effective with less blood loss,less pain than those of LADG.Moreover,it has comparable results to conventional LADG,with no increase of postoperative complications.

Key words: totally laparoscopic distal gastrectomy, laparoscopically assisted distal gastrectomy, Meta-analysis

CLC Number:

R656.6

TAO Youmao, JI Guofeng, MA Chong, XIAO Ling. Totally laparoscopic distal gastrectomy and laparoscopically assisted distal gastrectomy:A Meta-analysis on efficacy comparison[J].Journal of Jilin University Medicine Edition, 2015, 41(06): 1215-1223.

References

[1] Kitano S,Iso Y,Moriyama M,et al.Laparoscopy-assisted Billroth Ⅰ gastrectomy[J].Surg Laparosc Endosc,1994,4(2):146-148.

[2] Kim YW,Baik YH,Yun YH,et al.Improved quality of life outcomes after laparoscopy-assisted distal gastrectomy for early gastric cancer:results of a prospective randomized clinical trial[J].Ann Surg,2008,248(5):721-727.

[3] Yasunaga H,Horiguchi H,Kuwabara K,et al.Outcomes after laparoscopic or open distal gastrectomy for early-stage gastric cancer:a propensity-matched analysis[J].Ann Surg,2013,257(4):640-646.

[4] Athanasiou T,Al-Ruzzeh S,Kumar P,et al.Off-pump myocardial revascularization is associated with less incidence of stroke in elderly patients [J].Ann Thorac Surg,2004,77(2):745-753.

[5] Woo J,Lee JH,Shim KN,et al.Does the difference of invasiveness between totally laparoscopic distal gastrectomy and laparoscopy-assisted distal gastrectomy lead to a difference in early surgical outcomes? A prospective randomized trial[J].Ann Surg Oncol,2015,22(6):1836-1843.

[6] Kim HG,Park JH,Jeing SH,et al.Totally laparoscopic distal gastrectomy after learning curve completion:comparison with laparoscopy-assisted distal gastrectomy[J].J Gastric Cancer,2013,13(1):26-33.

[7] Kim DG,Choi YY,An JY,et al.Comparing the short-term outcomes of totally intracorporeal gastroduodenostomy with extracorporeal gastroduodenostomy after laparoscopic distal gastrectomy for gastric cancer:a single surgeon's experience and a rapid systematic review with meta-analysis[J].Surg Endosc,2013,27(9):3153-3161.

[8] Choi BS,Oh HK,Park SH,et al.Comparison of laparoscopy-assisted and totally laparoscopic distal gastrectomy:The short-term outcome at a low volume center[J].J Gastric Cancer,2013,13(1):44-50.

[9] Lee J,Kim D,Kim W.Comparison of laparoscopy-assisted and totally laparoscopic Billroth-Ⅱ distal gastrectomy for gastric cancer[J].J Korean Surg Soc,2012,82(3):135-142.

[10] Kinoshita T,Shibasaki H,Oshiro T,et al.Comparison of laparoscopy-assisted and total laparoscopic Billroth-I gastrectomy for gastric cancer:a report of short-term outcomes[J].Surg Endosc,2011,25(5):1395-1401.

[11] Kim BS,Yook JH,Choi YB,et al.Comparison of early outcomes of intracorporeal and extracorporeal gastroduodenostomy after laparoscopic distal gastrectomy for gastric cancer[J].J Laparoendosc Adv Surg Tech A,2011,21(5):387-391.

[12] Kim MG,Kawada H,Kim BS,et al.A totally laparoscopic distal gastrectomy with gastroduodenostomy (TLDG) for improvement of the early surgical outcomes in high BMI patients[J].Surg Endosc,2011,25(4):1076-1082.

[13] Ikeda O,Sakaguchi Y,Aoki Y,et al.Advantages of totally laparoscopic distal gastrectomy over laparoscopically assisted distal gastrectomy for gastric cancer[J].Surg Endosc,2009,23(10):2374-2379.

[14] Song KY,Park CH,Kang HC,et al.Is totally laparoscopic gastrectomy less invasive than laparoscopy-assisted gastrectomy?:prospective,multicenter study[J].J Gastrointest Surg,2008,12(6):1015-1021.

[15] Oki E,Sakaguchi Y,Ohgaki K,et al.The impact of obesity on the use of a totally laparoscopic distal gastrectomy in patients with gastric cancer[J].J Gastric Cancer,2012,12(2):108-112.

[16] Uyama I,Sugioka A,Matsui H,et al.Laparoscopic side-to-side esophagogastrostomy using a linear stapler afterproximal gastrectomy[J].Gastric Cancer,2001,4(2):98-102.

[17] Kanaya S,Gomi T,Momoi H,et al.Delta-shaped anastomosis in totally laparoscopic Billroth Ⅰ gastrectomy:a new technique of intraabdominal gastroduodenostomy[J].J Am Coll Surg,2002,195(2):284-287.

Totally laparoscopic distal gastrectomy and laparoscopically assisted distal gastrectomy:A Meta-analysis on efficacy comparison

PDF (PC)

Like

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Metrics

Comments

Recommended 10

[1]	Guangcai WAN,Hongshuai SUN,Hua ZHU,Xiuyan YU. Effect of NLR and PLR on prognosis of small-cell lung cancer patients received platinum-based first-line chemotherapy: A Meta-analysis [J]. Journal of Jilin University(Medicine Edition), 2021, 47(5): 1264-1272.
[2]	Yuan ZHAO, Dayong LIU, Yong TIAN, Dabing BAI. Effect of Carisolv chemomechanical method in treatment of deciduous tooth caries: A Meta-analysis [J]. Journal of Jilin University(Medicine Edition), 2021, 47(3): 694-700.
[3]	Guangcai WAN,Hongshuai SUN,Hua ZHU,Xiuyan YU. Meta-analysis on relationship between neutrophil/lymphocyte ratio and prognosis of patients with non-small cell lung cancer treated with EGFR-TKIs [J]. Journal of Jilin University(Medicine Edition), 2020, 46(6): 1267-1273.
[4]	YU Xiuyan, WAN Guangcai, SUN Hongshuai, ZHU Hua, GAO Haiyan, WU Xuefeng. Relationship between fibrinogen and prognosis of breast cancer patients:A Meta-analysis [J]. Journal of Jilin University(Medicine Edition), 2019, 45(05): 1092-1097.
[5]	ZHENG Taijing, BAI Yuanliang, ZHENG Jiawen, LIU Honghong, GUO Zijun, WANG Ping. Efficacies of clarithromycin and metronidazole in treatment of chronic periodontitis: A Meta-analysis [J]. Journal of Jilin University(Medicine Edition), 2019, 45(01): 130-136.
[6]	LU Mingyue, LI Jing. Relationships between expression of IGF-1 in cancer tissue of gastric cancer patients and clinicopathological parameters in China: A Meta-analysis [J]. Journal of Jilin University(Medicine Edition), 2019, 45(01): 137-142.
[7]	QI Lu, BAI Wei, YU Weiying, LI Yuanyuan, HUA Wanqing, KOU Changgui. Randomized controlled trials for curative effect of saxagliptin combined with insulin in treatment of patients with type 2 diabetes mellitus: Meta-analysis [J]. Journal of Jilin University(Medicine Edition), 2018, 44(06): 1235-1242.
[8]	NIU Huikun, QU Yangming, LI Meiqi, LI Lu, LYU Xin, SONG Yuanyuan, GAO Chunshi, LI Bo. Meta-analysis on efficacy and adverse effects of neoadjuvant chemotherapy combined with capecitabine in treatment of breast cancer [J]. Journal of Jilin University Medicine Edition, 2017, 43(06): 1171-1176.
[9]	YAO Yanan, YAO Hua, YAN Duoduo, LYU Kejia, GONG Lijun, WANG Guohua. Meta-analysis on correlation between oral lichen planus and Candida albicans infection [J]. Journal of Jilin University Medicine Edition, 2017, 43(05): 967-974.
[10]	NIU Meng, DENG Dayong, LI Yunpengfei, LIU Shuo, DING Jun. Values of MRE in diagnosis of stages of hepatic fibrosis:A Meta-analysis [J]. Journal of Jilin University Medicine Edition, 2017, 43(04): 787-793.
[11]	MA Ranyang, YU Hong, WANG Xin. Evaluation on clinical efficacy of hyperbaric oxygenation in treatment of sudden deafness:A Meta-analysis [J]. Journal of Jilin University Medicine Edition, 2017, 43(02): 298-305.
[12]	ZHANG Yang, WANG Junfeng, CAOHongyan, QIN Ling, XU Guoliang. Effectiveness and safety of Dengzhanhuasu and Dansheng Injection in treatment of patients with angina pectoris of coronary heart disease:A Meta-analysis [J]. Journal of Jilin University Medicine Edition, 2017, 43(02): 317-321.
[13]	XU Jin, CHEN Huaiji, XU Feng, WANG Qi, ZHANG Yuezhu, LIU Hongbo, ZHANG Tianrong, YE Lin. Association between phthalate ester exposure and population obesity:A Meta-analysis [J]. Journal of Jilin University Medicine Edition, 2017, 43(02): 306-310.
[14]	ZHANG Chengshuai, PAN Cuiliu, GAO Yanan, HAN Bing, ZHANG Zhiru, LI Feng. Meta-analysis on influence of androgen receptor in living conditions of patients with triple-negative breast cancer [J]. Journal of Jilin University Medicine Edition, 2017, 43(01): 73-79.
[15]	SUN Di, WANG Qi, CHEN Haiji, XU Feng, ZHANG Yuezhu, ZHANG Tianrong, LIU Hongbo, YE Lin. Changes of serum thyroid hormone levels in DEHP exposure population: A Meta-analysis [J]. Journal of Jilin University Medicine Edition, 2017, 43(01): 66-72.