| Objective: To evaluate the efficacy and safety of the preventive application of hyperthermic intraperitoneal chemotherapy in the treatment of local advanced gastric cancer standard D2 radical surgery,and to provide evidence for the research and clinical practice.Methods: We searched Pub Med,EMBASE,Cochrane Library Database,CNKI and Wan Fang data to collect randomized controlled trials(RCTs)on the comparison of standard D2 radical gastrectomy combined with hyperthermic intraperitoneal chemotherapy versus radical gastrectomy separately used in local advanced gastric cancer before January 2018.After screening for inclusion,data extraction,and quality assessment,meta-analysis was conducted by the Review Manager 5.3 software.Results: A total of 8 RCTs,involving 702 local advanced gastric cancepatients,were included.There were 353 patients in the study group and 349 patients in the control group.Compared with the control group,the study group had a higher 3-year survival rate [WMD=2.98,95%CI(1.99,4.47),P< 0.00001],higher 5-year survival rate[WMD=2.84,95%CI(1.69,4.77),P<0.0001],lower 3-year recurrence rate [WMD=0.27,95%CI(0.15,0.47),P<0.00001] and lower incidence of intestinal obstruction after surgery [WMD=0.32,95%CI(0.12,0.86),P=0.02].There were no significant differences in 1-year survival rate,1-year postoperative recurrence rate and postoperative anastomotic fistula incidence between the two groups.Conclusion: Based on current evidence,the hyperthermic intraperitoneal chemotherapy used in the standard D2 radical gastrectomy as a preventive measure can improve the 3-year survival rate and 5-year survival rate,reduce the 3-year recurrence rate of the local advanced gastric cancer patients.And the incidence of postoperative complications was not increased.It is safe and reliable,and can make patient long-term benefit. |
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