Laparoscopic vs open gastrectomy. An updated metaanalysis of randomised control trials for short term outcomes.

IntroductionAim of this metanalysis was to compare short term outcomes of laparoscopic and open gastrectomy for gastric cancer. Material and methodsEMBASE, MEDLINE, PubMed and the Cochrane Database were searched for randomized control trials comparing outcomes in patients undergoing laparoscopic gastrectomies with those patients undergoing open gastrectomies. The primary outcome was 30 days morbidity and mortality. Secondary outcomes studied included length of stay, blood loss, d2gastrectomies, lymph node retrieval, operative time, distal gastrectomy, wound complications and intraabdominal complications Systemic review and Metanalysis were done according to MOOSE and PRISMA guidelines. ResultsMorbidity was significantly low in laparoscopic group (P=0.003).There was no significant difference between mortality between the two groups. (P=0.75). There fewer wound complications in laparoscopic group, no difference intra-abdominal complications in both the groups. Blood loss was significantly lesser in laparoscopic group.(p <0.001). Hospital stay was similar in laparoscopic group. (P=0.30). Operative time was significantly higher in laparoscopic group. (P< 0.001). Laparoscopic group patients had less number of lymph node retrieval compared to laparoscopic group.(p = 0.002). Laparoscopic group also contained similar advanced staged gastric cancer than open gastrectomies. (p= 0.64) ConclusionsLaparoscopic gastrectomies were associated with better short term outcomes.