The Surgery-related Complications Of Totally Laparoscopic And Laparoscopy-assisted Distal Gastrectomy With Gastroduodenostomy For Distal Gastric Cancer: A Meta Analysis

Objective:From the point of view of Evidence-based medicine(EBM)to evaluate,objectively,the safety and feasibility of totally laparoscopic distal gastrectomy(TLDG)with gastroduodenostomy for distal gastric cancer,by making a Meta analysis about the surgeryrelated complications between TLDG and laparoscopy-assisted distal gastrectomy(LADG)with gastroduodenostomy.Methods:The database of Pubmed,Cochrane Library,Web of Science,Embase,Wanfang Database,China National Knowledge Infrastructure(CNKI)and China Biomedical Literature Database(CBM)were all retrieved.At the same time,other retrieval were used to collect the retrospective cohort studies about TLDG with intracorporeal gastroduodenostomy and LADG with extracorporeal gastroduodenostomy that published until January 25,2016.The language was limited to Chinese and English.Data related to clinical outcomes were extracted by two reviewers independently and checked alternatively according to the inclusion and exclusion criteria.Statistical analyses were carried out by the RevMan5.3 software.Results:A total of 7 studies were included,involving about 1929 patients(TLDG 551 and LADG 1378,respectively).The meta analysis results showed that there was no statistical significant in postoperative anastomotic leakage[RR=0.82,95%CI(0.22,3.08),P=0.77],anastomotic bleeding[RR=0.43,95%CI(0.12,1.51),P=0.19],anastomotic stenosis[RR=0.22,95%CI(0.02,1.87),P=0.16],abdominal abscess[RR=1.08,95%CI(0.30,3.85),P=0.90],intestinal obstruction[OR=0.42,95%CI(0.08,2.38),P=0.33],gastric paralysis[OR=0.58,95%CI(0.14,2.36),P=0.44]as well as incision complications[RR=0.52,95%CI(0.24,1.14),P=0.10].Conclusion:As for the surgery-related complications,there was no significant difference between TLDG and LADG with gastroduodenostomy.So the treatment of TLDG with gastroduodenostomy for distal gastric cancer is safe and feasible.