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Systematic review and meta-analysis of totally laparoscopic versus laparoscopic assisted distal gastrectomy for gastric cancer.

Zhang YX, Wu YJ, Lu GW, Xia MM - World J Surg Oncol (2015)

Bottom Line: Operative time was not statistically different between groups (P > 0.05).Compared to LADG, TLDG also involved lesser postoperative hospital stay (P < 0.01) and earlier time to soft diet intake (P < 0.05).TLDG may be a technically safe, feasible, and favorable approach in terms of better cosmesis, less blood loss, and faster recovery compared with LADG.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgical Oncology, Yinzhou Affiliated Hospital of Medical College of Ningbo University, 251 Baizhang Road, Ningbo, Zhejiang, 315040, People's Republic of China. 248791664@qq.com.

ABSTRACT

Background: Totally laparoscopic distal gastrectomy (TLDG) has been developed in the hope of improving surgical quality and overcoming the limitations of conventional laparoscopic assisted distal gastrectomy (LADG) for gastric cancer. The aim of this study was to determine the extent of evidence in support of these ideals.

Methods: A systematic review of the two operation types (LADG and TLDG) was carried out to evaluate short-term outcomes including duration of operation, retrieved lymph nodes, estimated blood loss, resection margin status, technical postoperative complications, and hospital stay.

Results: Twelve non-randomized observational clinical studies involving 2,255 patients satisfied the eligibility criteria. Operative time was not statistically different between groups (P > 0.05). The number of retrieved lymph nodes and the resection margin length in TLDG were comparable with those in LADG. Estimated blood loss was significantly less in TLDG than that in LAG (P < 0.01). Compared to LADG, TLDG also involved lesser postoperative hospital stay (P < 0.01) and earlier time to soft diet intake (P < 0.05). Time to flatus and postoperative complications were similar for those two operative approaches.

Conclusions: TLDG may be a technically safe, feasible, and favorable approach in terms of better cosmesis, less blood loss, and faster recovery compared with LADG.

No MeSH data available.


Related in: MedlinePlus

Flow chart of literature search strategies. LADG, laparoscopic assisted distal gastrectomy; TLDG, totally laparoscopic distal gastrectomy [10-27].
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Fig1: Flow chart of literature search strategies. LADG, laparoscopic assisted distal gastrectomy; TLDG, totally laparoscopic distal gastrectomy [10-27].

Mentions: The initial search strategy retrieved 2,668 publications in English. After the titles and abstracts were reviewed, papers without a comparison of LADG and TLDG were excluded, which left 18 comparative studies, 6 [10-15] of which did not meet the inclusion criteria and were excluded. This left a total of 12 observational studies [16-27], all of which were accessible in full-text format. A flow chart of the search strategies, which includes the reasons for excluding studies, is illustrated in FigureĀ 1.Figure 1


Systematic review and meta-analysis of totally laparoscopic versus laparoscopic assisted distal gastrectomy for gastric cancer.

Zhang YX, Wu YJ, Lu GW, Xia MM - World J Surg Oncol (2015)

Flow chart of literature search strategies. LADG, laparoscopic assisted distal gastrectomy; TLDG, totally laparoscopic distal gastrectomy [10-27].
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4384388&req=5

Fig1: Flow chart of literature search strategies. LADG, laparoscopic assisted distal gastrectomy; TLDG, totally laparoscopic distal gastrectomy [10-27].
Mentions: The initial search strategy retrieved 2,668 publications in English. After the titles and abstracts were reviewed, papers without a comparison of LADG and TLDG were excluded, which left 18 comparative studies, 6 [10-15] of which did not meet the inclusion criteria and were excluded. This left a total of 12 observational studies [16-27], all of which were accessible in full-text format. A flow chart of the search strategies, which includes the reasons for excluding studies, is illustrated in FigureĀ 1.Figure 1

Bottom Line: Operative time was not statistically different between groups (P > 0.05).Compared to LADG, TLDG also involved lesser postoperative hospital stay (P < 0.01) and earlier time to soft diet intake (P < 0.05).TLDG may be a technically safe, feasible, and favorable approach in terms of better cosmesis, less blood loss, and faster recovery compared with LADG.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgical Oncology, Yinzhou Affiliated Hospital of Medical College of Ningbo University, 251 Baizhang Road, Ningbo, Zhejiang, 315040, People's Republic of China. 248791664@qq.com.

ABSTRACT

Background: Totally laparoscopic distal gastrectomy (TLDG) has been developed in the hope of improving surgical quality and overcoming the limitations of conventional laparoscopic assisted distal gastrectomy (LADG) for gastric cancer. The aim of this study was to determine the extent of evidence in support of these ideals.

Methods: A systematic review of the two operation types (LADG and TLDG) was carried out to evaluate short-term outcomes including duration of operation, retrieved lymph nodes, estimated blood loss, resection margin status, technical postoperative complications, and hospital stay.

Results: Twelve non-randomized observational clinical studies involving 2,255 patients satisfied the eligibility criteria. Operative time was not statistically different between groups (P > 0.05). The number of retrieved lymph nodes and the resection margin length in TLDG were comparable with those in LADG. Estimated blood loss was significantly less in TLDG than that in LAG (P < 0.01). Compared to LADG, TLDG also involved lesser postoperative hospital stay (P < 0.01) and earlier time to soft diet intake (P < 0.05). Time to flatus and postoperative complications were similar for those two operative approaches.

Conclusions: TLDG may be a technically safe, feasible, and favorable approach in terms of better cosmesis, less blood loss, and faster recovery compared with LADG.

No MeSH data available.


Related in: MedlinePlus