التفاصيل البيبلوغرافية
| العنوان: |
Short-Term Outcomes Analysis Comparing Open, Laparoscopic, Laparoscopic-Assisted, and Robotic Distal Gastrectomy for Locally Advanced Gastric Cancer: A Randomized Trials Network Analysis. |
| المؤلفون: |
Manara, Michele, Aiolfi, Alberto, Sozzi, Andrea, Calì, Matteo, Grasso, Federica, Rausa, Emanuele, Bonitta, Gianluca, Bonavina, Luigi, Bona, Davide |
| المصدر: |
Cancers; May2024, Vol. 16 Issue 9, p1620, 16p |
| مصطلحات موضوعية: |
SURGICAL robots, GASTRECTOMY, EFFECT sizes (Statistics), STOMACH tumors, LAPAROSCOPIC surgery, META-analysis, RANDOMIZED controlled trials, HOSPITAL mortality, SURGICAL blood loss, SYSTEMATIC reviews, SURGICAL complications, ODDS ratio, HEALTH outcome assessment, LENGTH of stay in hospitals, TIME |
| مستخلص: |
Simple Summary: The role of minimally invasive surgery for the treatment of locally advanced gastric cancer (AGC) remains controversial. The present network meta-analysis demonstrates that short-term outcomes for open (Op-DG), totally laparoscopic (Lap-DG), laparoscopic-assisted (LapAs-DG), and robotic distal gastrectomy (Rob-DG) seem comparable. Similarly, the total number of retrieved lymph nodes and resection margin appear equivalent. LapAs-DG, Lap-DG, and Rob-DG performed in referral centers by dedicated surgeons have comparable short-term outcomes to Op-DG for locally AGC. Background. Minimally invasive surgery for the treatment of locally advanced gastric cancer (AGC) is debated. The aim of this study was to execute a comprehensive assessment of principal surgical treatments for resectable distal gastric cancer. Methods. Systematic review and randomized controlled trials (RCTs) network meta-analysis. Open (Op-DG), laparoscopic-assisted (LapAs-DG), totally laparoscopic (Lap-DG), and robotic distal gastrectomy (Rob-DG) were compared. Pooled effect-size measures were the risk ratio (RR), the weighted mean difference (WMD), and the 95% credible intervals (CrIs). Results. Ten RCTs (3823 patients) were included. Overall, 1012 (26.5%) underwent Lap-DG, 902 (23.6%) LapAs-DG, 1768 (46.2%) Op-DG, and 141 (3.7%) Rob-DG. Anastomotic leak, severe complications (Clavien–Dindo > 3), and in-hospital mortality were comparable. No differences were observed for reoperation rate, pulmonary complications, postoperative bleeding requiring transfusion, surgical-site infection, cardiovascular complications, number of harvested lymph nodes, and tumor-free resection margins. Compared to Op-DG, Lap-DG and LapAs-DG showed a significantly reduced intraoperative blood loss with a trend toward shorter time to first flatus and reduced length of stay. Conclusions. LapAs-DG, Lap-DG, and Rob-DG performed in referral centers by dedicated surgeons have comparable short-term outcomes to Op-DG for locally AGC. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
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