Meta-analysis of safety and efficacy on paraaortic lymphadenectomy in gastric cancer / 中华胃肠外科杂志
Chinese Journal of Gastrointestinal Surgery
; (12): 119-124, 2010.
Article
en Zh
| WPRIM
| ID: wpr-259324
Biblioteca responsable:
WPRO
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of paraaortic lymphadenectomy in gastric cancer with meta-analysis.</p><p><b>METHODS</b>Randomized controlled trial comparing D(2)/D(3) and D(2)/D(3) plus paraaortic lymphadenectomy in gastric cancer were identified by two investigators after search strategy was established. Seven randomized controlled trials with 1446 cases were included in this meta-analysis. Fixed effect model or random model was separately used to evaluate the safety and efficacy of paraaortic lymphadenectomy in gastric cancer.</p><p><b>RESULTS</b>Total complication rate in the D(2)/D(3) plus paraaortic lymphadenectomy group was significantly higher than that in the D(2)/D(3) group (RR 1.34, 95% CI 1.03-1.75, P=0.03), while surgery associated complication between the two groups was almost the same. Lymphorrhea and severe diarrhea was more common in the D(2)/D(3) plus paraaortic lymphadenectomy (RR 16.23 and 9.56, 95% CI 1.99-131.98 and 1.70-53.67, respectively). Anastomotic leak, pancreatic fistula, abdominal abscess, ileus, postoperative bleeding and wound infection were similar. There were no advantages in operating time, amount of blood transfusion, in-hospital stay, reoperation, recurrence and 5-year survival favoring the paraaortic lymphadenectomy group except intra-operative blood loss and rate of blood transfusion (WMD 202.95, 95% CI 116.80-289.10; RR 1.93, 95% CI 1.20-3.10).</p><p><b>CONCLUSIONS</b>Paraaortic lymphadenectomy is associated with increased total complication without altering postoperative recurrence and survival. Strict large-scale multicenter controlled trials with long-term follow-up are required.</p>
Texto completo:
1
Base de datos:
WPRIM
Asunto principal:
Aorta Abdominal
/
Complicaciones Posoperatorias
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Neoplasias Gástricas
/
Cirugía General
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Ensayos Clínicos Controlados Aleatorios como Asunto
/
Escisión del Ganglio Linfático
Tipo de estudio:
Clinical_trials
/
Systematic_reviews
Límite:
Humans
Idioma:
Zh
Revista:
Chinese Journal of Gastrointestinal Surgery
Año:
2010
Tipo del documento:
Article