A comparison of surgical procedures and postoperative cares for minimally invasive laparoscopic gastrectomy and open gastrectomy in gastric cancer

摘要

Minimally invasive, laparoscopic gastrectomy (LG) has assumed an ever-expanding role in gastric cancer treatment. Accumulating data so far seem to suggest that LG is at least a viable alternative of conventional open gastrectomy (OG) in different contexts. However, even though reviews and meta-analyses have compared the advantages and limitations of each option, it is still controversial whether LG is a better alternative to OG, especially in advanced gastric cancer (AGC). The major goal of this study is to evaluate the readouts of LG, in comparison with OG. A literature search was performed for studies published from 2009 to 2013. Medical records of 20868 gastric cancer patients from 32 independent studies were reviewed and analyzed. All 32 studies concluded that LG is at least comparable with OG. LG is superior to OG in offering less blood loss, shorter hospital stay, and lower risk of complications, although LG is probably inferior in operative time, and not different from OG in mortality. Considering the merits and the potential future technical improvement, it is reasonable to speculate that LG may eventually replace OG in most clinical contexts.