Meta-analysis of perioperative outcomes of laparoscopic-assisted pyloric sparing gastrectomy for early gastric cancer / 国际外科学杂志

ABSTRACT

Objective:To conduct a Meta-analysis of the efficacy and safety of laparoscopy-assisted pylorus-preserving gastrectomy(LPPG) and laparoscopy-assisted distal gastrectomy(LDG) in early gastric cancer(EGC).Methods:Searched Web of Science, Cochrane library, Embase, Chinese Biomedical Medical Database, CNKI, Wanfang Database to identify all qualified studies comparing LPPG and LDG in EGC. The retrieval time was from the database establishment to October 2020. Measurement data with normal distribution were represented as ( Mean± SD). Comparing two groups by mean difference(MD) with 95% confidence interval(CI) for contious outcomes and odds ratio(OR) with 95% CI for dichotomous data.The RevMan software was used to analyze the perioperative outcome. Results:A total of 10 studies were included, with a total of 1613 patients, 624 in the LPPG group and 989 in the LDG group. Operation time, intraoperative blood loss, postoperative anal exhaust time, hospital stay, and overall complication rate of LPPG were similar to LDG.Compared with the LDG group, the LPPG group had fewer lymph node dissections ( MD=-2.51, 95% CI -4.31~-0.71, P=0.006), longer postoperative gastric tube indwelling time ( MD=1.05, 95% CI 0.31~1.80, P=0.006), and a higher incidence of delayed gastric emptying ( P<0.01). There was no statistically significant difference between the two groups in terms of other perioperative complications. Conclusion:LPPG is a safe and feasible surgical method for the treatment of EGC, and can be used as an alternative to LDG.