Comparison Of Clinical Safety And Efficacy Between Extraperitoneal And Transperitoneal Approach In The Laparoscopic Lymphadenectomy Of Gynecologic Cancers: A Meta-analysis

Objective The main aim of our study is to review the till now available literature data for comparing the clinical safety and efficacy between extraperitoneal and transperitoneal approach in the laparoscopic lymphadenectomy of gynecologic cancersMethods A thorough and systematic search was performed in electronic databases of Pub Med?EMBASE?Cochrane?Scopus?CNKI?CBM?Wanfang data to February 2017.Manual search of relevant journals and books.Collection of non-randomized control trials at home and abroad.All patients underwent laparoscopic surgery,the experimental group was treated by extraperitoneal approach,the control group was treated with transperitoneal surgery.Primary endpoints included operative time,intraoperative blood loss,lymphocysts,intraoperative mortality,postoperative morbidity,number of harvested lymph nodes.Rev Man 5.3 software was used for Meta analysis.Results A total of 7 non-randomized control trials involving 539 patients(n=271 in the extraperitoneal group and n=268 in the transperitoneal group)were included.Compared to the transperitoneal approach,extraperitoneal approach in the laparoscopic lymphadenectomy demonstrated a significantly shorter operative time,lower lymphocyst morbidity,intraoperative morbidity and postoperative morbidity.No significant differences were observed between groups treated with an extraperitoneal or transperitoneal approach for the following criteria: intraoperative blood loss and number of harvested lymphnodes.Conclusion Extraperitoneal approach in the laparoscopic lymphadenectomy of gynecologic cancers has obvious advantages of operative time,lymphocyst morbidity,intraoperative and postoperative complication rate,Intraoperative bleeding and number of lymphnodes dissection were comparable.