Safety and Effectiveness of Laparoscopy-Assisted Distal Gastrectomy with D2 Lymph Node Dissection for Distal Gastric Cancer of Chinese Patients: A Systematic Review_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 MAOJing ¹ , MAJi-chun ¹ , JIANGLei ² , CHANGHang ¹ , ZHUWei-peng ¹ , HUXiao-dong ¹ ,  WANGXiao-wei ²

1. The First Clinical Medicine College, Lanzhou University, Lanzhou 730000, Gansu Province, China;
2. Department of Oncological Surgery, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China;

Corresponding author：

WANGXiao-wei, Email: 739221251@qq.com

Keywords：

Laparoscopy; Laparotomy; D2 lymph node dissection; Distal gastric cancer; Systematic review

DOI：

10.7507/1007-9424.20140169

Video：

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Objective To systemically evaluate safety and effectiveness of laparoscopy-assisted distal gastrectomy (LADG) and conventional open distal gastrostomy(CODG) with D2 lymph node dissection for Chinese patients with distal gastric cancer. Methods Literature were searched in PubMed database, the Cochrane Library, China science citation database (CSCD), Wanfang database, China science and technology journal database (CSTJ), China biomedical literature database (CBM), and China academic journal network publishing database (CAJD) to identify clinical random controlled trials, comparing safety and effectiveness of LADG and CODG with D2 lymph node dissection for Chinese patients with distal gastric cancer. The retrieval time was from the inception to Jun. 2013. Meta-analysis was performed by Review Manager 5.2 software. Results A total of 7 clinical random controlled trials including 548 patients were analyzed. Compared with CODG group, LADG group had less blood loss (MD=-94.02, 95% CI:-140.96--47.07), shorter postoperative hospital stay(MD=-3.66, 95% CI:-5.76--1.57), earlier postoperative ambulation time(MD=-1.95, 95% CI:-2.74--1.17), earlier postoperative exhaust time (MD=-1.67, 95% CI:-2.05--1.30), lower incidence of complications(OR=0.26, 95% CI:0.14-0.51), P<0.050. But the operation time was longer in LADG group (MD=35.01, 95% CI:10.41-59.61, P=0.005). There was no significant difference between LADG group and CODG group on number of lymph node which were dissected during the operation (MD=-0.24, 95% CI:-0.99-0.51, P=0.530). Conclusion The short-term outcome and safety of LADG for Chinese patients with distal gastric cancer is superior to CODG, but LADG prolongs the operation time and its long-term outcome should be proved by further outcomes of clinical controlled trials.

Citation： MAOJing, MAJi-chun, JIANGLei, CHANGHang, ZHUWei-peng, HUXiao-dong, WANGXiao-wei. Safety and Effectiveness of Laparoscopy-Assisted Distal Gastrectomy with D2 Lymph Node Dissection for Distal Gastric Cancer of Chinese Patients: A Systematic Review. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(6): 707-714. doi: 10.7507/1007-9424.20140169 Copy

1.	郑朝旭,郑荣寿,陈万青.中国2009年胃癌发病与死亡分析[J].中国肿瘤, 2013, 22(5):327-332.
2.	季加孚.胃癌的综合治疗[J/CD].中国医学前沿杂志:电子版, 2010, 2(2):31-37.
3.	帅磊渊,刘福亮,李益飞,等.远端胃癌腹腔镜D2根治术与传统开腹术近期疗效观察[J].重庆医科大学学报, 2013, 38(4):432-434.
4.	Viñuela EF, Gonen M, Brennan MF, et al.Laparoscopic versus open distal gastrectomy for gastric cancer:a meta-analysis of randomized controlled trials and high-quality nonrandomized studies[J].Ann Surg, 2012, 255(3):446-456.
5.	Chen XZ, Hu JK, Yang K, et al.Short-term evaluation of laparo-scopy-assisted distal gastrectomy for predictive early gastric cancer:a meta-analysis of randomized controlled trials[J].Surg Laparosc Endosc Percutan Tech, 2009, 19(4):277-284.
6.	Higgins JPT, Green S.Cochrane handbook for systematic reviews of interventions version 5.1.0[EB/OL].2013-09-01. http://handbook.cochrane.org/.
7.	董峰,牛跃平,孙培春,等.腹腔镜辅助下与开腹胃癌根治术治疗进展期远端胃癌临床对照研究[J].中华实用诊断与治疗杂志, 2013, 27(5):457-459.
8.	邬颖杰,陆国文,章懿欣.腹腔镜在远端胃癌D2根治术中的应用价值[J].肿瘤学杂志, 2013, 19(4):289-291.
9.	周锋.腹腔镜辅助与开腹远端胃癌D2根治术的临床分析[J].河北医药, 2012, 34(16):2437-2438.
10.	张振翼,秦瑞峰,袁增江,等.进展期胃癌腹腔镜D2根治术的临床分析[J].中国医药导报, 2012, 9(34):46-47.
11.	罗国德,曹永宽,张林,等.腹腔镜与开腹手术对进展期胃癌D2根治术的临床对比分析[J].华西医学, 2011, 26(9):1323-1326.
12.	魏寿江,王崇树,李勋,等.腹腔镜与开腹进展期远端胃癌D2根治术2年疗效对比[J].中国内镜杂志, 2010, 16(9):918-920.
13.	杜建军,王飞,赵青川,等.完全腹腔镜胃癌D2根治术150例报道[J/CD].中华腔镜外科杂志:电子版, 2012, 5(4):298-302.
14.	Kitano S, Iso Y, Moriyama M, et al.Laparoscopy-assisted Billroth Ⅰgastrectomy[J].Surg Laparosc Endosc, 1994, 4(2):146-148.
15.	Fujiwara M, Kodera Y, Kasai Y, et al.Laparoscopy-assisted distal gastrectomy with systemic lymph node dissection for early gastric carcinoma:a review of 43 cases[J].J Am Coll Surg, 2003, 196(1):75-81.
16.	Lee SI, Choi YS, Park DJ, et al.Comparative study of laparoscopy-assisted distal gastrectomy and open distal gastrectomy[J].J Am Coll Surg, 2006, 202(6):874-880.
17.	Du J, Zheng J, Li Y, et al.Laparoscopy-assisted total gastrectomy with extended lymph node resection for advanced gastric cancer-reports of 82 cases[J].Hepatogastroenterology, 2010, 57(104):1589-1594.
18.	黄江龙,卫洪波,郑宗珩,等.进展期远端胃癌腹腔镜与开腹根治术的对照研究[J].中华胃肠外科杂志, 2012, 15(6):615-617.
19.	Jiang L, Yang KH, Guan QL, et al.Laparoscopy-assisted gastrectomy versus open gastrectomy for resectable gastric cancer:an update meta-analysis based on randomized controlled trials[J].Surg Endosc, 2013, 27(7):2466-2480.
20.	Liang Y, Li G, Chen P, et al.Laparoscopic versus open gastrectomy for early distal gastric cancer:a meta-analysis[J].ANZ J Surg, 2011, 81(10):673-680.
21.	Moore MJ, Bennett CL.The learning curve for laparoscopic cholecystectomy.The Southern Surgeons Club[J].Am J Surg, 1995, 170(1):55-59.
22.	Ohtani H, Tamamori Y, Noguchi K, et al.Meta-analysis of laparoscopy-assisted and open distal gastrectomy for gastric cancer[J].J Surg Res, 2011, 171(2):479-485.
23.	Smith DD, Schwarz RR, Schwarz RE.Impact of total lymph node count on staging and survival after gastrectomy for gastric cancer:data from a large US-population database[J].J Clin Oncol, 2005, 23(28):7114-7124.
24.	Etoh T, Shiraishi N, Kitano S.Laparoscopic gastrectomy for cancer[J].Dig Dis, 2005, 23(2):113-118.
25.	余佩武,罗华星.腹腔镜胃癌根治术的现在与发展[J].中国普外基础与临床杂志, 2007, 14(5):506-509.

1. 郑朝旭,郑荣寿,陈万青.中国2009年胃癌发病与死亡分析[J].中国肿瘤, 2013, 22(5):327-332.
2. 季加孚.胃癌的综合治疗[J/CD].中国医学前沿杂志:电子版, 2010, 2(2):31-37.
3. 帅磊渊,刘福亮,李益飞,等.远端胃癌腹腔镜D2根治术与传统开腹术近期疗效观察[J].重庆医科大学学报, 2013, 38(4):432-434.
4. Viñuela EF, Gonen M, Brennan MF, et al.Laparoscopic versus open distal gastrectomy for gastric cancer:a meta-analysis of randomized controlled trials and high-quality nonrandomized studies[J].Ann Surg, 2012, 255(3):446-456.
5. Chen XZ, Hu JK, Yang K, et al.Short-term evaluation of laparo-scopy-assisted distal gastrectomy for predictive early gastric cancer:a meta-analysis of randomized controlled trials[J].Surg Laparosc Endosc Percutan Tech, 2009, 19(4):277-284.
6. Higgins JPT, Green S.Cochrane handbook for systematic reviews of interventions version 5.1.0[EB/OL].2013-09-01. http://handbook.cochrane.org/.
7. 董峰,牛跃平,孙培春,等.腹腔镜辅助下与开腹胃癌根治术治疗进展期远端胃癌临床对照研究[J].中华实用诊断与治疗杂志, 2013, 27(5):457-459.
8. 邬颖杰,陆国文,章懿欣.腹腔镜在远端胃癌D2根治术中的应用价值[J].肿瘤学杂志, 2013, 19(4):289-291.
9. 周锋.腹腔镜辅助与开腹远端胃癌D2根治术的临床分析[J].河北医药, 2012, 34(16):2437-2438.
10. 张振翼,秦瑞峰,袁增江,等.进展期胃癌腹腔镜D2根治术的临床分析[J].中国医药导报, 2012, 9(34):46-47.
11. 罗国德,曹永宽,张林,等.腹腔镜与开腹手术对进展期胃癌D2根治术的临床对比分析[J].华西医学, 2011, 26(9):1323-1326.
12. 魏寿江,王崇树,李勋,等.腹腔镜与开腹进展期远端胃癌D2根治术2年疗效对比[J].中国内镜杂志, 2010, 16(9):918-920.
13. 杜建军,王飞,赵青川,等.完全腹腔镜胃癌D2根治术150例报道[J/CD].中华腔镜外科杂志:电子版, 2012, 5(4):298-302.
14. Kitano S, Iso Y, Moriyama M, et al.Laparoscopy-assisted Billroth Ⅰgastrectomy[J].Surg Laparosc Endosc, 1994, 4(2):146-148.
15. Fujiwara M, Kodera Y, Kasai Y, et al.Laparoscopy-assisted distal gastrectomy with systemic lymph node dissection for early gastric carcinoma:a review of 43 cases[J].J Am Coll Surg, 2003, 196(1):75-81.
16. Lee SI, Choi YS, Park DJ, et al.Comparative study of laparoscopy-assisted distal gastrectomy and open distal gastrectomy[J].J Am Coll Surg, 2006, 202(6):874-880.
17. Du J, Zheng J, Li Y, et al.Laparoscopy-assisted total gastrectomy with extended lymph node resection for advanced gastric cancer-reports of 82 cases[J].Hepatogastroenterology, 2010, 57(104):1589-1594.
18. 黄江龙,卫洪波,郑宗珩,等.进展期远端胃癌腹腔镜与开腹根治术的对照研究[J].中华胃肠外科杂志, 2012, 15(6):615-617.
19. Jiang L, Yang KH, Guan QL, et al.Laparoscopy-assisted gastrectomy versus open gastrectomy for resectable gastric cancer:an update meta-analysis based on randomized controlled trials[J].Surg Endosc, 2013, 27(7):2466-2480.
20. Liang Y, Li G, Chen P, et al.Laparoscopic versus open gastrectomy for early distal gastric cancer:a meta-analysis[J].ANZ J Surg, 2011, 81(10):673-680.
21. Moore MJ, Bennett CL.The learning curve for laparoscopic cholecystectomy.The Southern Surgeons Club[J].Am J Surg, 1995, 170(1):55-59.
22. Ohtani H, Tamamori Y, Noguchi K, et al.Meta-analysis of laparoscopy-assisted and open distal gastrectomy for gastric cancer[J].J Surg Res, 2011, 171(2):479-485.
23. Smith DD, Schwarz RR, Schwarz RE.Impact of total lymph node count on staging and survival after gastrectomy for gastric cancer:data from a large US-population database[J].J Clin Oncol, 2005, 23(28):7114-7124.
24. Etoh T, Shiraishi N, Kitano S.Laparoscopic gastrectomy for cancer[J].Dig Dis, 2005, 23(2):113-118.
25. 余佩武,罗华星.腹腔镜胃癌根治术的现在与发展[J].中国普外基础与临床杂志, 2007, 14(5):506-509.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Safety and Effectiveness of Laparoscopy-Assisted Distal Gastrectomy with D2 Lymph Node Dissection for Distal Gastric Cancer of Chinese Patients: A Systematic Review

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