Laparoscopy-assisted versus open distal gastrectomy for early gastric cancer: A meta-analysis based on seven randomized controlled trials

• Compared with ODG, LADG presents better superiority in the treatment of early gastric cancer.
• Seven random controlled trials were included in the study, the evidence is more convicing.
• Our meta-analysis is the most accurate and updated work present in the literature.

ObjectiveThis study aims to answer the superiority of comparing laparoscopy-assisted distal gastrectomy (LADG) with open distal gastrectomy (ODG) in the treatment early gastric cancer (EGC).Material and methodsA comprehensive search up to May 31, 2014 was conducted on PubMed, Web of science, and the Cochrane Library. All eligible studies comparing LADG versus ODG were included. Data synthesis and statistical analysis were performed using RevMan 5.2 software.ResultsSeven randomized controlled trials (RCTs) totaling 390 patients (195 LADG and 195 ODG) were analyzed. Compared to ODG, LADG showed longer operative time (WMD = 79.60; 95%CI = 59.86 to 99.35; P < 0.00001), but was associated with less blood loss (WMD = −108.11; 95%CI = −145.97 to −70.26; P < 0.00001), fewer administered analgesics (WMD = −1.70; 95%CI = − 2.19 to −1.22; P < 0.00001), fewer number of harvested lymph node (WMD = −2.77; 95%CI = −4.38 to −1.16; P = 0.0007), lower incidence of postoperative complications (OR = 0.26; 95%CI = 0.13 to 0.54; P = 0.0003), shorter postoperative hospital stay (WMD = −1.0; 95% CI = −1.83 to −0.16; P = 0.02) and earlier passage of flatus (WMD = −0.62; 95% CI = −0.96 to −0.27; P = 0.0005).ConclusionThis meta-analysis demonstrated that LADG significantly reduced blood loss, decreased the frequency of analgesic administration, faster recovery, a shorter hospital stay and fewer postoperative complications compared with ODG, though at the price of longer operative times and the number of harvested lymph nodes lesser as compared to ODG.

Overall postoperative complications after laparoscopy-assisted distal gastrectomy (LADG) versus conventional open gastrectomy (ODG) for early gastric cancer. CI, confidence interval; OR Odds Ratio.Figure optionsDownload high-quality image (109 K)Download as PowerPoint slide