Meta-analysis of laparoscopy-assisted distal gastrectomy with D2 lymph node dissection for gastric cancer

J Surg Oncol. 2012 Mar;105(3):297-303. doi: 10.1002/jso.22098. Epub 2011 Sep 22.


Background: To assess the value of laparoscopy-assisted distal gastrectomy with D2 dissection for treatment of gastric cancer.

Methods: We collected studies that have compared laparoscopy-assisted distal gastrectomy (LADG) and open distal gastrectomy (ODG) with D2 dissection for treatment of gastric cancer in the past 15 years. Data of interest for LADG and ODG were subjected to meta-analysis using a fixed-effect and random-effect model.

Results: We analyzed 8 studies that included 1,065 patients. There were significant differences in operating time, blood loss, time to first flatus and first eating, postoperative hospital stay, and postoperative complications between the LADG and ODG groups. Compared with the ODG group, blood loss and complications in the LADG group decreased, time to recovery of gastrointestinal function and hospitalization period were shorter, but operating time was longer. There were no significant differences in the number of harvested lymph nodes, mortality, and rate of recurrence between the groups.

Conclusions: Compared with ODG, LADG with D2 dissection has the advantages of minimal invasion, faster recovery, and fewer complications, and it can achieve the same degree of radicality and short-term prognosis as ODG. The drawbacks are that the operating time is slightly longer and long-term prognosis is not clear.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Blood Loss, Surgical
  • Eating
  • Flatulence
  • Gastrectomy / methods*
  • Humans
  • Laparoscopy*
  • Length of Stay
  • Lymph Node Excision*
  • Postoperative Complications
  • Recovery of Function
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*
  • Time Factors