Lymph Node Dissection For Gastric Cancer In Different Ways Compared The Efficacy And Safety Evaluation System

Objective:To assess the effectiveness of different lymph node dissection for treatment of gastric carcinoma. Methods:Randomized controlled trials (RCTs) were identified by means of MEDLINE,EMBASE, Cochrane Controlled Trials Register databases, and Chinese Biomedical Database, as well as by selecting references from relevant articles.Results:Overall 6 RCTs(1943 Patients,10 articles)were eligible and were included into the meta----analysis.In D1 and D2 surgery group, operative mortality was 2.8%and 6.1% respectively with OR 0.43 and 95% CI (0.23,0.78);the postoperative morbidity was 26.5% and 44.5% respectively with OR 0.40 and 95% CI (0.31,0.52); The operative time was MD -54.00and95%CI(-75.74,-32.26); the 3 years survival rate was 61.6% and 57.5% respectively with OR 1.21 and 95% CI (0.93,1.58); the 5 years survival rate was 47.1% and 50.2% respectively with OR 0.89,and 95% CI (0.69,1.16); In D2 versus D3 surgery group, the operative mortality was 0.9% and 1.9% respectively with OR 0.49 and 95% CI (0.15,1.65);the postoperative morbidity was 22.8% and 32.4% respectively with OR 0.61 and 95% CI (0.45,0.83); The operative time was MD-29.10 and 95% CI(-159.44,101.23);The hospital stay time:MD 0.13 and 95% CI(-23.38, 23.65);the 5 years survival rate was 59.7% and 60.7% respectively with OR 0.96 and 95% CI (0.72,1.28); Conclusion:D1 group compared with the D2 group:D1 group compared with the D2, D1 group had lower operative mortality and postoperative complication rate than the D2 group, and 3-year survival was no significant difference, D1 group was lower 5-year survival rate than D2 group; D2 group compared with the D3 group, D2 group had a lower incidence of postoperative complications, and operative mortality, operative time, 3 and 5-year survival rate was no difference.