Laparoscopy-assisted versus open gastrectomy with D2 lymph node dissection for advanced gastric cancer: a...

Area of Science:

• Surgical Oncology
• Gastroenterology
• Minimally Invasive Surgery

Background:

• Advanced gastric cancer (ADG) treatment often involves gastrectomy with D2 lymph node dissection.
• Laparoscopy-assisted gastrectomy (LAG) is increasingly adopted as an alternative to open gastrectomy (OG).
• Comparative safety and efficacy data for LAG versus OG in ADG remain limited.

Purpose of the Study:

• To conduct a meta-analysis comparing laparoscopy-assisted gastrectomy (LAG) with open gastrectomy (OG) for advanced gastric cancer (ADG).
• To evaluate the safety and efficacy of LAG versus OG, including oncological outcomes and postoperative recovery.

Main Methods:

• Comprehensive literature search across PubMed, Web of Science, and Embase.
• Meta-analysis of 11 studies involving 1904 patients (982 LAG, 922 OG) using RevMan 5.1 software.
• Analysis of pooled risk ratios (RR) and weighted mean differences (WMD) with 95% confidence intervals (CI).

Main Results:

• LAG demonstrated significantly less blood loss, shorter first flatus time, and reduced postoperative hospital stay compared to OG.
• Laparoscopy-assisted gastrectomy was associated with lower overall morbidity but longer operation times.
• No significant differences were observed in harvested lymph nodes, tumor size, mortality, cancer recurrence, or 3-year survival rates between LAG and OG.

Conclusions:

• Laparoscopy-assisted gastrectomy (LAG) provides advantages of minimal invasion, faster recovery, and fewer complications for advanced gastric cancer (ADG) treatment.
• LAG achieves comparable radicality, lymph node yield, and short-term/long-term prognosis to open gastrectomy (OG).
• LAG is a safe and effective alternative to OG for ADG, despite a slightly longer operative time.