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

Title
Laparoscopic total gastrectomy as a valid procedure to treat gastric cancer option both in early and advanced stage: A systematic review and meta-analysis
Authors
Oh, YoujinKim, Min SeoLee, Yoon TeakLee, Chang MinKim, Jong HanPark, Sungsoo
Ewha Authors
이윤택
Issue Date
2020
Journal Title
EJSO
ISSN
0748-7983JCR Link

1532-2157JCR Link
Citation
EJSO vol. 46, no. 1, pp. 33 - 43
Keywords
Total gastrectomyLaparoscopic total gastrectomyOpen total gastrectomyMeta-analysisEarly gastric cancerAdvanced gastric cancer
Publisher
ELSEVIER SCI LTD
Indexed
SCIE; SCOPUS WOS scopus
Document Type
Review
Abstract
Although 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 to employ quantitative synthesis in evaluation of long-term oncologic validity of LTG and OTG in AGC, with LN dissection and N stage controlled setting. Non-inferiority of LTG on oncologic outcome and superiority of LTG on perioperative outcome lead to a conclusion that LTG has potential as a valid treatment modality in AGC. (C) 2019 Elsevier Ltd, BASO - The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
DOI
10.1016/j.ejso.2019.08.018
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의료원 > 의료원 > Journal papers
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