Laparoscopic surgery for gastric cancer: a systematic review

Background: The objective of this paper is to systematically review current literature on laparoscopic surgery for gastric cancer in terms of current indications and feasibility as well as short-term and long-term postoperative outcomes. Methods: A systematic review was conducted with respect to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines using PubMed and is up-to-date until January 1, 2014. Results: A total of 99 papers matched the inclusion criteria and comprised of 92 case-control studies and 7 randomized controlled trials (RCTs). The majority of these papers focused on short-term outcomes of laparoscopy-assisted distal gastrectomy (LADG), which are superior compared to open distal gastrectomy (ODG). Lymphadenectomy extent, morbidity, and mortality rates as well as disease-free and overall survival did not differ significantly between LADG and ODG groups. Finally, the implementation of laparoscopic gastrectomy was assessed in advanced gastric carcinoma, obese, and elderly patients. Conclusions: This systematic review revealed that laparoscopic surgery is safe and effective for the treatment of gastric cancer. LADG offers better short-term and similar long-term results to ODG. Well-designed multicenter RCTs are needed to better understand the limitations of oncologic laparoscopic gastrectomy.

Duke Scholars

Author Konstantinos Economopoulos