| Objective To assess the clinical value(effectiveness and safety)of laparoscopic distal gastrectomy for advanced gastric cancer.Method Search the national and international databases such as Pubmed?Medline?Cochrane ?CNKI?VIP?EMbase?CBM about the randomized controlled trials or retrospective studies compareing laproscopic gastretomy and conventional open surgery with D2 lymphadenectomy for advanced gastric cancer.collect data that included operation time,blood loss,number of dissected lymph nodes,time to first flatus,time to first liquid diet,length of postoperative stay,incidence of complications.and meta-analysis were performed with Review Manager4.2.Result A total of 12 studies(1127patients)conform to inclusion criteria were involved.Compared with open surgery group,the operative time(MD=26.97,95% CI=23.59~30.36,P<0.00001)was longer,but blood loss(MD=-94.76,95% CI=-101.29~-88.24,P<0.00001),time to first flatus(MD=-1.06,95% CI=-1.15~-0.97,P<0.00001),time to liquid diet(MD=-1.62,95% CI=-1.80~-1.44,P<0.00001),length of hospital stay(MD=-1.99,95% CI=-2.25~-1.73,P<0.00001)and the incidence of postoperative complications(OR=0.43,95% CI=0.30~0.62,P<0.00001)were reduced and the number of dissected lymph nodes(MD=-0.20,95% CI=-0.50~0.10,P=0.19)has no significant differences.Conclusion Laparoscopic distal gastrectomy has the advantages of minimal invasion,faster recovery and fewer complications,and can achieve the same results and short-term effectiveness and safety as open radical operation.But its longer-term outcome should be evaluate by further larger scale outcomes of studies. |
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