Meta-analysis of laparoscopy assisted distal gastrectomy and conventional open distal gastrectomy for EGC

In recent decades, laparoscopy assisted distal gastrectomy (LADG) has been introduced to treat early gastric cancer (EGC). This study evaluated the safety and efficacy of laparoscopy assisted and conventional open distal gastrectomy for EGC. Comprehensive searches of PubMed, EmBase, Cochrane Controlled Trials Register and Chinese Biomedical Database (CBM) were performed. Included literature was evaluated using the Newcastle-Ottawa Scale. Original data were extracted, pooled odds ratio (OR) and 95% confidence intervals (CI) were calculated using RevMan 5.0. Eight RCTs of 734 patients were included in the study. Compared to CODG, LADG increases the operation time (weighted mean difference [WMD]: 63.35; 95% confidence interval [CI]: 57.96, 68.74; P<0.01), reduces intraoperative blood loss (WMD: -127.95; 95% CI: -147.97, -107.93; P<0.01), decreases number of harvested lymph nodes (WMD: -4.21; 95% CI: -6.10, -2.31; P<0.01), forwards oral intake time (WMD:-0.43; 95% CI: -0.61, -0.24; P<0.01), and shortens hospital stay(WMD: -1.29; 95% CI: -1.76, -0.83; P<0.01). There is no significant difference in postoperative complications(OR: 0.70; 95% CI: 0.46, 1.06; P=0.09). All these findings indicate that LADG for EGC is feasible and safe.