Laparoscopic versus conventional open resection for early distal gastric cancer: a meta-analysis on the number of retrieved lymph nodes / 中华胃肠外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To compare the number of retrieved lymph nodes (LN) between laparoscopic resection and conventional open resection for early distal gastric cancer with meta-analysis.</p><p><b>METHODS</b>Original articles published from January 2000 to December 2008 were searched in the MEDLINE, EMBASE and Cochrane Controlled Trials Register. According to the criterion, 14 articles were identified which compared the number of retrieved lymph nodes between laparoscopic resection and conventional open resection for early distal gastric cancer. Data were extracted from these trials by 3 reviewers independently and analyzed by Rev Man 5.0 software.</p><p><b>RESULTS</b>A total of 1454 patients with early gastric cancer were enrolled, including 815 patients in the laparoscopic group and 630 patients in the conventional group. The mean number of dissected lymph nodes per patient was 3.26 less in the laparoscopic group as compared to the conventional group (WMD -3.26,95% CI -6.24~-0.27,P=0.03). The differences were not statistically significant in the articles published during 2005-2008 years (WMD -2.84, 95% CI -6.79~1.11, P=0.16), in D(1)(+)alpha/beta lymph node dissection (WMD -2.80, 95% CI -7.57~1.97, P=0.25), and in retrospective non-randomized trials (WMD -2.89, 95% CI -6.48~0.70,P=0.11).</p><p><b>CONCLUSION</b>With the improvement in surgical skills, laparoscopic surgery and open surgery do not differ significantly in the number of retrieved lymph nodes for early distal gastric cancer with D(1)(+)alpha/beta lymph node dissection.</p>