Department of Gastrointestinal Surgery, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
J Surg Oncol. 2012 Mar;105(3):297-303. doi: 10.1002/jso.22098. Epub 2011 Sep 22.
To assess the value of laparoscopy-assisted distal gastrectomy with D2 dissection for treatment of gastric cancer.
We collected studies that have compared laparoscopy-assisted distal gastrectomy (LADG) and open distal gastrectomy (ODG) with D2 dissection for treatment of gastric cancer in the past 15 years. Data of interest for LADG and ODG were subjected to meta-analysis using a fixed-effect and random-effect model.
We analyzed 8 studies that included 1,065 patients. There were significant differences in operating time, blood loss, time to first flatus and first eating, postoperative hospital stay, and postoperative complications between the LADG and ODG groups. Compared with the ODG group, blood loss and complications in the LADG group decreased, time to recovery of gastrointestinal function and hospitalization period were shorter, but operating time was longer. There were no significant differences in the number of harvested lymph nodes, mortality, and rate of recurrence between the groups.
Compared with ODG, LADG with D2 dissection has the advantages of minimal invasion, faster recovery, and fewer complications, and it can achieve the same degree of radicality and short-term prognosis as ODG. The drawbacks are that the operating time is slightly longer and long-term prognosis is not clear.
评估腹腔镜辅助下 D2 淋巴结清扫术治疗胃癌的价值。
我们收集了过去 15 年来比较腹腔镜辅助下远端胃切除术（LADG）和开腹远端胃切除术（ODG）加 D2 淋巴结清扫术治疗胃癌的研究。使用固定效应和随机效应模型对 LADG 和 ODG 的数据进行荟萃分析。
我们分析了 8 项研究，共纳入 1065 例患者。LADG 组与 ODG 组在手术时间、出血量、首次排气和首次进食时间、术后住院时间和术后并发症方面存在显著差异。与 ODG 组相比，LADG 组的出血量和并发症减少，胃肠功能恢复时间和住院时间缩短，但手术时间延长。两组的淋巴结清扫数目、死亡率和复发率无显著差异。
与 ODG 相比，LADG 加 D2 淋巴结清扫术具有微创、恢复更快、并发症更少的优点，能够达到与 ODG 相同的根治性和短期预后。缺点是手术时间略长，长期预后尚不清楚。
