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Ludwig K.
Klinikum Südstadt Rostock
Schneider-Koriath S.
Klinikum Südstadt Rostock
Bernhardt J.
Klinikum Südstadt Rostock
Current data of evidence-based medicine on laparoscopic gastrectomy for gastric cancer
Journal: Endoscopic Surgery. 2022;28(5): 52‑62
Read: 1843 times
To cite this article:
Ludwig K, Schneider-Koriath S, Bernhardt J. Current data of evidence-based medicine on laparoscopic gastrectomy for gastric cancer. Endoscopic Surgery.
2022;28(5):52‑62. (In Russ.)
https://doi.org/10.17116/endoskop20222805152
The following study is a systematically review of the current evidence of laparoscopic distal and total gastrectomy in comparison to open surgery. A systematic search of EMBASE and Pubmed was conducted. Out of 1.034 hits a total of 257 randomized (RCT) and non-randomized (non-RCT) studies fulfilled criteria to compare feasibility, intra- and postoperative outcome, oncological quality (R0, lymphnode harvest), morbidity and mortality and the oncological long-term outcome between laparoscopic vs. open gastrectomy for early (EGC) and advanced (AGC) gastric cancer. For EGC and laparoscopic distal resection (LDG) and total gastrectomy (LTG) a total of 10 RCT and 6 non-RCT, including 4.329 patients (lap. 2.010 vs. open 2.319) were selected. On high evidence level there is no significant difference in terms of feasibility, intraoperative outcome and quality, mortality and long-term oncological outcome compared to open surgery. Patients after LDG and LTG showed a significant faster recovery and lower morbidity. In contrast, operative time for LDG and LTG was significant longer than that for ODG and OTG. For distal AGC and LDG totally 6 RCT, including 2.806 patients (LDG 1.410 vs ODG 1.369) benefits similar high evidence and results. The Evidence for LTG in cases of AGC is quiet lower. Currently only 6 non-RCT, including 1.090 patients (LTG 539 vs OTG 551) are available and showed similar results to LDG. High quality RCT’s are further necessary. Laparoscopic gastrectomy shows better recovery and oncological equivalence in comparison to open gastrectomy.
Authors:
Ludwig K.
Klinikum Südstadt Rostock
Schneider-Koriath S.
Klinikum Südstadt Rostock
Bernhardt J.
Klinikum Südstadt Rostock
Received:
15.02.2022
Accepted:
10.03.2022
List of references:
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