Laparoscopic total gastrectomy as a valid procedure to treat gastric cancer option both in early and advanced stage: A systematic review and meta-analysis

Publication date: Available online 23 August 2019Source: European Journal of Surgical OncologyAuthor(s): Youjin Oh, Min Seo Kim, Yoon Teak Lee, Chang Min Lee, Jong Han Kim, Sungsoo ParkAbstractAlthough laparoscopic total gastrectomy (LTG) compared to open total gastrectomy (OTG) has been widely used for advanced gastric cancer patients, its oncologic validity is yet to be proven. We performed systemic review and meta-analysis to compare LTG versus OTG for early and advanced stages of gastric cancer. Short- and long-term outcomes of both procedures were analyzed using original studies collected by searching Google Scholar, Medline, PubMed, Embase, and Cochrane library in accordance with the PRISMA guidelines. To analyze procedures more precisely, we categorized studies into advanced gastric cancer (AGC) and early gastric cancer (EGC) groups and matched lymph node (LN) dissection, and metastasis ratio. Nineteen studies with a total of 3943 patients were included. LTG required more operative time and had less dissected LNs, indicating a favorable quality of OTG. However, LTG was superior with less blood loss, a shorter postoperative hospital stay, and lower postoperative complication rates. The 5-year survival rate was similar in both groups in which extent of LN dissection and lymph node metastasis ratio were controlled. Although more LNs were removed in OTG, the discrepancy had an insignificant impact on the survival rate. To the best of our knowledge, this study is the first ...
Source: European Journal of Surgical Oncology (EJSO) - Category: Surgery Source Type: research