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Totally laparoscopic vs. laparoscopically assisted distal gastrectomy for gastric cancer: a meta-analysis.

BACKGROUND/AIMS
Laparoscopic surgery has become common in the treatment of gastric cancer due to the improvement of both techniques and devices for laparoscopic surgery. This study compares totally laparoscopic distal gastrectomy (TLDG) with laparoscopically assisted distal gastrectomy (LADG) implemented by experienced laparoscopic surgeons.


METHODOLOGY
Studies and relevant literature regarding the formation of LADG vs. TLDG were searched in PubMed, Embase and WanFang database. Operative time, bleeding volume, number of retrieved lymph nodes, time to first flatus, duration of postoperative hospitalization and postoperative complications in LADG and TLDG were pooled and compared using a meta-analysis. The odds ratios (ORs) and weighted mean different (WMD) were calculated with 95% confidence intervals (CIs) to evaluate the influence of TLDG.


RESULTS
Five recent studies including 652 patients in total were included in this meta-analysis. These studies demonstrated that compared with LADG, TLDG has less bleeding (p <0.05), shorter time to first flatus (p <0.05), and lower rates of postoperative complications (p <0.01). The operation time, the mean number of lymph nodes retrieved and duration of postoperative hospitalization were not statistically significant (p >0.05).


CONCLUSIONS
Compared with LADG, TLDG can significantly reduce bleeding, time to first flatus and rates of postoperative complications. Therefore, it was considered a useful technique for patients with gastric cancer.