Meta-analysis of safety and efficacy on paraaortic lymphadenectomy in gastric cancer / 中华胃肠外科杂志
Chinese Journal of Gastrointestinal Surgery
;
(12): 119-124, 2010.
Article
in Chinese
| WPRIM
| ID: wpr-259324
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of paraaortic lymphadenectomy in gastric cancer with meta-analysis.</p><p><b>METHODS</b>Randomized controlled trial comparing D(2)/D(3) and D(2)/D(3) plus paraaortic lymphadenectomy in gastric cancer were identified by two investigators after search strategy was established. Seven randomized controlled trials with 1446 cases were included in this meta-analysis. Fixed effect model or random model was separately used to evaluate the safety and efficacy of paraaortic lymphadenectomy in gastric cancer.</p><p><b>RESULTS</b>Total complication rate in the D(2)/D(3) plus paraaortic lymphadenectomy group was significantly higher than that in the D(2)/D(3) group (RR 1.34, 95% CI 1.03-1.75, P=0.03), while surgery associated complication between the two groups was almost the same. Lymphorrhea and severe diarrhea was more common in the D(2)/D(3) plus paraaortic lymphadenectomy (RR 16.23 and 9.56, 95% CI 1.99-131.98 and 1.70-53.67, respectively). Anastomotic leak, pancreatic fistula, abdominal abscess, ileus, postoperative bleeding and wound infection were similar. There were no advantages in operating time, amount of blood transfusion, in-hospital stay, reoperation, recurrence and 5-year survival favoring the paraaortic lymphadenectomy group except intra-operative blood loss and rate of blood transfusion (WMD 202.95, 95% CI 116.80-289.10; RR 1.93, 95% CI 1.20-3.10).</p><p><b>CONCLUSIONS</b>Paraaortic lymphadenectomy is associated with increased total complication without altering postoperative recurrence and survival. Strict large-scale multicenter controlled trials with long-term follow-up are required.</p>
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Aorta, Abdominal
/
Postoperative Complications
/
Stomach Neoplasms
/
General Surgery
/
Randomized Controlled Trials as Topic
/
Lymph Node Excision
Type of study:
Controlled clinical trial
/
Systematic reviews
Limits:
Humans
Language:
Chinese
Journal:
Chinese Journal of Gastrointestinal Surgery
Year:
2010
Type:
Article
Similar
MEDLINE
...
LILACS
LIS