Jun Gao, Ping Li, Jie Chen, Qi Lu, Tang Dong, Wang DaoRong
Hepatogastroenterology. 2013 Sep;60(126):1530-4. doi: 10.5754/hge121240.
BACKGROUND/AIMS: Laparoscopic surgery has become common in the treatment of gastric cancer due to the improvement of both techniques and devices for laparoscopic surgery. This study compares totally laparoscopic distal gastrectomy (TLDG) with laparoscopically assisted distal gastrectomy (LADG) implemented by experienced laparoscopic surgeons.
Studies and relevant literature regarding the formation of LADG vs. TLDG were searched in PubMed, Embase and WanFang database. Operative time, bleeding volume, number of retrieved lymph nodes, time to first flatus, duration of postoperative hospitalization and postoperative complications in LADG and TLDG were pooled and compared using a meta-analysis. The odds ratios (ORs) and weighted mean different (WMD) were calculated with 95% confidence intervals (CIs) to evaluate the influence of TLDG.
Five recent studies including 652 patients in total were included in this meta-analysis. These studies demonstrated that compared with LADG, TLDG has less bleeding (p <0.05), shorter time to first flatus (p <0.05), and lower rates of postoperative complications (p <0.01). The operation time, the mean number of lymph nodes retrieved and duration of postoperative hospitalization were not statistically significant (p >0.05).
Compared with LADG, TLDG can significantly reduce bleeding, time to first flatus and rates of postoperative complications. Therefore, it was considered a useful technique for patients with gastric cancer.
背景/目的：由于腹腔镜手术技术和设备的改进，腹腔镜手术在胃癌治疗中已变得很常见。本研究比较了由经验丰富的腹腔镜外科医生实施的全腹腔镜远端胃切除术（TLDG）和腹腔镜辅助远端胃切除术（LADG）。
在PubMed、Embase和万方数据库中检索关于LADG与TLDG对比的研究及相关文献。汇总并使用荟萃分析比较LADG和TLDG的手术时间、出血量、清扫淋巴结数量、首次排气时间、术后住院时间及术后并发症。计算比值比（OR）和加权平均差（WMD）及其95%置信区间（CI），以评估TLDG的影响。
本荟萃分析纳入了5项近期研究，共652例患者。这些研究表明，与LADG相比，TLDG出血更少（p<0.05）、首次排气时间更短（p<0.05）、术后并发症发生率更低（p<0.01）。手术时间、平均清扫淋巴结数量和术后住院时间差异无统计学意义（p>0.05）。
与LADG相比，TLDG可显著减少出血、缩短首次排气时间并降低术后并发症发生率。因此，它被认为是一种对胃癌患者有用的技术。
