目的    系统评价腹腔镜与传统开腹手术治疗早期胃癌的安全性和可行性。方法    检索Pumed数据库、Cochrane library、Embase、中国生物医学文献数据库（CBM）、中国期刊全文数据库（CNKI）、中文科技期刊数据库，全面检索有关腹腔镜与传统开腹手术治疗胃癌并发表于2002—2012年10年间的随机对照试验。由两名评价者独立评价并交叉核对纳入文献的方法学质量，采用RevMan 5.1软件进行统计分析。 结果    共纳入7篇随机对照研究，共计699例胃癌病人。Meta分析结果显示：与传统开腹手术相比，腹腔镜手术在手术淋巴结清扫数目［加权均数差（WMD）=3.87，其95%CI（-5.87，-1.87），P=0.0002］、术中失血量［标准化均数差（SMD）=0.78，其95%CI（-0.94，-0.63） P<0.00001］、手术时间［WMD：62.67  95%CI（57.35，67.99） P<0.00001］、术后总并发症发生率［OR=0.42，其95%CI（0.27，0.67），P=0.0002］和肺部并发症发生率［OR=0.42，其95%CI（0.17，1.00），P=0.05］方面差异具有统计学意义，而在术后5年存活率［54.8%、55.7%］、围手术期病死率［OR=0.96，其95%CI（0.24，3.94），P=0.96］和术后复发率［OR=1.27，其95%CI（0.48，3.34），P=0.62］方面差异无统计学意义。 结论    当前临床研究证据表明与传统开腹手术治疗胃癌相比，腹腔镜胃癌根治术后并发症少、近期疗效优于传统开腹手术，远期疗效相当，但技术难度大，手术时间长。

Laparoscopic and conventional open gastrectomy in the treatment of early gastric cancer: A meta-analysis of effectiveness and safety        XU Tian-en, FAN Wen-juan, JIANG Lei, et al. Department of Oncology, First Affiliated Hospital of Lanzhou University, Lanzhou 730000, China
Corresponding author: GUAN Quan-lin, E-mail：ldyyzlwk2012@163.com
Abstract    Objective    To compare the effectiveness and safety of laparoscopic and conventional open gastrectomy in the treatment of early gastric cancer. Methods    Randomized controlled trials (RCTs) of LADG and CODG published between 2002 and 2012 in PubMed, Cochrane library, Embase, Chinese Biomedical Literature Database (CBM), CNKI and VIP were searched. All the data were analyzed by 2 reviewers independently using RevMan5.1software. Results Seven RCTs were included totally including 699 patients with gastric cancer. The result of meta-analysis showed that: There is significant difference in the number of lymph nodes dissected [WMD(weighted mean differences)=3.87 95%CI（-5.87, -1.87） P=0.0002], intraoperative blood loss [SMD(standardized mean differences)=0.78 95%CI（-0.94, -0.63）P<0.00001], operation time [WMD：62.67 95%CI（57.35, 67.99）P<0.00001], postoperative total complication incidence [OR=0.42 95%CI（0.27, 0.67）P=0.0002] and pulmonary complication incidence [OR=0.42 95%CI（0.17, 1.00）P=0.05] between conventional open gastrectomy group and laparoscopic group. No statistical significance difference was found in postoperative survival rate in 5 years [54.8%, 55.7%], the perioperative mortality [OR=0.96 95%CI（0.24, 3.94） P=0.96] and postoperative recurrence rate [OR=1.27 95%CI（0.48, 3.34）P=0.62]. Conclusion    The current clinical evidence shows that compared with conventional open gastrectomy, laparoscopic gastrectomy has less postoperative total complications with the similar short-term outcome but laparoscopic gastrectomy is a procedure with high surgical technique and long operation time.