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.	?鄭朝旭,鄭榮壽,陳萬青.中國2009年胃癌發病與死亡分析[J].中國腫瘤, 2013, 22(5):327-332.
2.	季加孚.胃癌的綜合治療[J/CD].中國醫學前沿雜志:電子版, 2010, 2(2):31-37.
3.	帥磊淵,劉福亮,李益飛,等.遠端胃癌腹腔鏡D2根治術與傳統開腹術近期療效觀察[J].重慶醫科大學學報, 2013, 38(4):432-434.
4.	Vi?uela 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,牛躍平,孫培春,等.腹腔鏡輔助下與開腹胃癌根治術治療進展期遠端胃癌臨床對照研究[J].中華實用診斷與治療雜志, 2013, 27(5):457-459.
8.	鄔穎杰,陸國文,章懿欣.腹腔鏡在遠端胃癌D2根治術中的應用價值[J].腫瘤學雜志, 2013, 19(4):289-291.
9.	周鋒.腹腔鏡輔助與開腹遠端胃癌D2根治術的臨床分析[J].河北醫藥, 2012, 34(16):2437-2438.
10.	張振翼,秦瑞峰,袁增江,等.進展期胃癌腹腔鏡D2根治術的臨床分析[J].中國醫藥導報, 2012, 9(34):46-47.
11.	羅國德,曹永寬,張林,等.腹腔鏡與開腹手術對進展期胃癌D2根治術的臨床對比分析[J].華西醫學, 2011, 26(9):1323-1326.
12.	魏壽江,王崇樹,李勛,等.腹腔鏡與開腹進展期遠端胃癌D2根治術2年療效對比[J].中國內鏡雜志, 2010, 16(9):918-920.
13.	杜建軍,王飛,趙青川,等.完全腹腔鏡胃癌D2根治術150例報道[J/CD].中華腔鏡外科雜志:電子版, 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.	黃江龍,衛洪波,鄭宗珩,等.進展期遠端胃癌腹腔鏡與開腹根治術的對照研究[J].中華胃腸外科雜志, 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,羅華星.腹腔鏡胃癌根治術的現在與發展[J].中國普外基礎與臨床雜志, 2007, 14(5):506-509.

1. ?鄭朝旭,鄭榮壽,陳萬青.中國2009年胃癌發病與死亡分析[J].中國腫瘤, 2013, 22(5):327-332.
2. 季加孚.胃癌的綜合治療[J/CD].中國醫學前沿雜志:電子版, 2010, 2(2):31-37.
3. 帥磊淵,劉福亮,李益飛,等.遠端胃癌腹腔鏡D2根治術與傳統開腹術近期療效觀察[J].重慶醫科大學學報, 2013, 38(4):432-434.
4. Vi?uela 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,牛躍平,孫培春,等.腹腔鏡輔助下與開腹胃癌根治術治療進展期遠端胃癌臨床對照研究[J].中華實用診斷與治療雜志, 2013, 27(5):457-459.
8. 鄔穎杰,陸國文,章懿欣.腹腔鏡在遠端胃癌D2根治術中的應用價值[J].腫瘤學雜志, 2013, 19(4):289-291.
9. 周鋒.腹腔鏡輔助與開腹遠端胃癌D2根治術的臨床分析[J].河北醫藥, 2012, 34(16):2437-2438.
10. 張振翼,秦瑞峰,袁增江,等.進展期胃癌腹腔鏡D2根治術的臨床分析[J].中國醫藥導報, 2012, 9(34):46-47.
11. 羅國德,曹永寬,張林,等.腹腔鏡與開腹手術對進展期胃癌D2根治術的臨床對比分析[J].華西醫學, 2011, 26(9):1323-1326.
12. 魏壽江,王崇樹,李勛,等.腹腔鏡與開腹進展期遠端胃癌D2根治術2年療效對比[J].中國內鏡雜志, 2010, 16(9):918-920.
13. 杜建軍,王飛,趙青川,等.完全腹腔鏡胃癌D2根治術150例報道[J/CD].中華腔鏡外科雜志:電子版, 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. 黃江龍,衛洪波,鄭宗珩,等.進展期遠端胃癌腹腔鏡與開腹根治術的對照研究[J].中華胃腸外科雜志, 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,羅華星.腹腔鏡胃癌根治術的現在與發展[J].中國普外基礎與臨床雜志, 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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