| Background: Gastric cancer is famous for its high morbidity and mortality worldwide,with900000newly diagnosed cases and700000death per year. Exceeding260000casesdied because of this disease. But little is known about the epidemiology of gastric cancer inChongqing, China.Currently, gastric cancer is treated by combination therapy with surgery as principlemethod. Surgery for gastric cancer includes two kinds: open surgery and laparoscopic assistedsurgery. After surgery, chemotherapy, biological therapy, radiotherapy and physical therapyare also adopted. Although there are reports comparing the efficacy and safety of open surgeryand laparoscopic surgery, but long-term survival data are limited, so high level evidence areneeded for clinical doctors to make choices.Objectives：To study the distribution characteristics of gastric cancer in Chongqing. Andconduct a systematic review and meta analysis to compare the efficacy and safety oflaparoscopic assisted surgery with open surgery for gastric cancer.Methods:(1)376cases of gastric cancer (260males，116females) between January2005and December2010in Southwest Hospital were collected and analyzed retrospectively.Individual characteristics, distribution of year, distribution of season, distribution of district,and disease part were analyzed by SPSS for Windows13.0.(2) We searched PubMed，Cochrane Library，EMBASE，CBM using ‘gastric cancer’ and‘laparoscopic’ between1994and September2012. We included randomized clinicaltrials(RCT), which compare the efficacy and safety of open surgery with laparoscopic assistedsurgery The include trials were graded methodologically. We selected studies and extracteddata. The data was input and analyzed with the latest Cochrane review manager software(RevMan5.0). Results: Part I:(1) The patients were from64local areas. And the most one wasShapingba District;(2) Age group of51~60accounted for the largest propor tion;(3) Theratio of gastric antrum cancer was the largerst;(4) The majority of patients needed surgery(78.0%);(5) Compared with the traditional open surgery, laparoscopy-assisted surgery waswith longer time duration of operation but less intraoperative blood loss.Part II: In systematic review and meta analysis, of1004citations initially identified,5papers, with326patients, met our eligibility criteria. Compared with open surgery,laparoscopic assisted surgery is of similary overall survival, longer surgery time, less lymphnode, but less intraoperative blood loss, shorter hospital stay, shorter time to eat after surgery,less frequency of pain-killers and better quality of life(p<0.05).Conclusion: The epidemiology of gastric cancer in Chongqing is similar with that inwhole China, although with special characteristics, and the knowledge of the characteristics isbeneficial to the prevention and treatment.The systematic review and meta-analysis demonstrates an advantage of laparoscopicassisted surgery for treatment of gastric cancer. |
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