272P - Meta-analysis of intracorporeal or extracorporeal anastomosis after laparoscopic total gastrectomy for gastric cancer: Which is better?

Date 17 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Gastric Cancer
Surgical Oncology
Presenter An Nguyen
Citation Annals of Oncology (2016) 27 (suppl_9): ix68-ix85. 10.1093/annonc/mdw582
Authors A.T.T. Nguyen
  • Gcsp, National Cancer Center, 10408 - Gyeonggi-do/KR

Abstract

Background

Totally laparoscopic total gastrectomy (TLTG) is still uncommon because of the difficult of esophago-jejunostomy technique laparoscopically which almost depends on surgeon. So far, the benefit as well as the reality of TLTG is under controversial. The aim of this study was to determine the useful extent of this procedure.

Methods

The literature on comparative studies of TLTG versus LATG up to now were extensively retrieved from database PubMed, Cochrane library, EMBASE. The operation times, blood loss, time to flatus, time to first oral intake, postoperative hospital stay, postoperative complications especially anastomosis leakage and anastomosis stenosis were analyzed. The statistical analysis was performed with STATs 13.0 software.

Results

Nine studies met the inclusion criteria for meta-analysis. Odds ratios (ORs) and weighted mean differences (WMDs) were calculated with 95% confidence intervals (CIs) to evaluate the effect of TLTG. Compare to LATG, TLTG experienced less blood loss [weighted mean difference (WMD)=-16.25 ml, 95% confidence interval (CI: -29.25,-3.25, p = 0.270)], smaller incision length (WMD= -2.74, 95% CI:-4.60, -0.89;p

Conclusions

TLTG is shown by this meta-analysis to be efficient and safe in the short term outcome. Future studies should evaluate oncological outcomes with adequate long-term follow-up, preferably in randomized trials.

Legal entity responsible for the study

National Cancer Center-Korea

Funding

National Cancer Center-Korea

Disclosure

All authors have declared no conflicts of interest.