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.