An Nguyen, MD, MS. Oncology Hospital Ho Chi Minh
Background: The benefits of totally laparoscopic total gastrectomy (TLTG) over laparoscopy assisted total gastrectomy (LATG) in operative outcomes and complications still remain controversial. This study aimed to compare the outcomes of TLTG with those of LATG by using a meta-analysis.
Methods: We searched PubMed, EMBASE, and Cochrane library in May, 2016 to locate prospective or retrospective studies on surgical outcomes of TLTG versus LATG. The outcome measures were postoperative complications such as anastomosis leakage and anastomosis stenosis, operation time, blood loss, time to flatus, time to first oral intake, and postoperative hospital stay. We calculated a pooled odds ratio (OR) with its 95% confidence interval (CI) for dichotomous variables and a weighted mean difference (WMD) with its 95% CI for continuous variables based on a random-effects model.
Results: Out of 948 articles, nine studies meeting the predetermined selection criteria were included in the final analysis. In this meta-analysis, the results showed that the operating time was substantially shorter in TLTG group than in LATG group (WMD = -13.44, 95%CI -25.93–0.95). Also, compare with LATG, TLTG showed less intraoperative blood loss (WMD = -16.25, 95% CI -29.25–3.25) and smaller incision length (WMD = -2.74, 95% CI -4.60–0.89). There was no significant difference between TLTG and LATG in the complication rate such as anastomosis leakage and stricture as well as bleeding. Also, no significant difference was observed in bowl recovery, number of retrieved lymph node, and proximal margin.
Conclusion: This meta-analysis showed that TLTG is superior to LATG in operating time, intraoperative blood loss and incision length and is similar in complication rate, bowl recovery, number of retrieved lymph node, and proximal margin. Further randomized controlled trials are needed to confirm the superiority of TLTG over LATG.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 85151
Program Number: P707
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
sages_adbutler_leaderboard