Objective: Laparoscopic-assisted total gastrectomy (LATG) is the most commonly used method for laparoscopic treatment of gastric upper gastric cancer. However, because of the difficulties of total laparoscopic reconstruction, especially in vivo esophageal jejunum anastomosis is not easy to complete, resulting in a large number of complete laparoscopic total gastrectomy (TLTG), but it is worth to explore the complete laparoscopy the clinical value of total gastrectomy. This study from the perspective of evidence-based medicine TLTG treatment of gastric cancer in the safety and feasibility of the recent and effective.
Methods: A comparative study of the efficacy of TLTG and LATG in the treatment of upper gastric cancer was published in 2017. Meta-analysis was performed using RenMan 5.3 software.
Results: A total of 912 patients with gastric cancer were enrolled in this study. Among them, 425 LATG patients and 487 TLTG patients were all Asian populations. The results of meta-analysis showed that there was no significant difference in TLTG between operation time, proximal margin, lymph node dissection, postoperative complications and the most important complication of the anastomotic fistula compared with LATG (MD=-65.91, 95% CI: -114.18 ~ -1.7.65, P<0.05), but the length of incision was shorter (P<0.05), but the length of incision was shorter (MD=-4.91, 95 (MD=-1.07, 95% CI: -1.88 ~ -0.26, P<0.05), the time of premature feeding was earlier (MD=-1.07, 95% CI: -1.88 ~ -0.26, P<0.05) (MD=-1.55, 95% CI: -2.70 ~ -0.40, P<0.05). The postoperative hospital stay was shorter (MD=-1.55, 95% CI: -2.70 ~ -0.40, P<0.05).
Conclusion: TLTG is safe and feasible in the treatment of upper gastric cancer in Asian population, and has the advantages of quick recovery after incision.