Oncologic value of laparoscopy-assisted distal gastrectomy for advanced gastric cancer: A systematic review and meta-analysis

Paolo Aurello, Andrea Sagnotta, Irene Terrenato, Giammauro Berardi, Giuseppe Nigri, Francesco D'Angelo, Giovanni Ramacciato

Research output: Contribution to journalReview articlepeer-review


Background: The oncologic validity of laparoscopic-assisted distal gastrectomy (LADG) in the treatment of advanced gastric cancer (AGC) remains controversial. This study is a systematic review and meta-analysis of the available evidence. Materials and Methods: A comprehensive search was performed between 2008 and 2014 to identify comparative studies evaluating morbidity/mortality, oncologic surgery-related outcomes, recurrence and survival rates. Data synthesis and statistical analysis were carried out using RevMan 5.2 software. Results: Eight studies with a total of 1456 patients were included in this analysis. The complication rate was lower in LADG [odds ratio (OR) 0.59; 95% confidence interval (CI) = 0.42-0.83; P <0.002]. The in-hospital mortality rate was comparable (OR 1.22; 95% CI = 0.28-5-29, P = 0.79). There was no significant difference in the number of harvested lymph nodes, resection margins, cancer recurrence rate, cancer-related mortality or overall and disease-free survival (OS and DFS, respectively) rates between the laparoscopic and the open groups (P > 0.05). Conclusion: The current study supports the view that LADG for AGC is a feasible, safe and effective procedure in selected patients. Adequate lymphadenectomy, resection margins, recurrence, cancer-related mortality and long-term outcomes appear equivalent to open distal gastrectomy (ODG).

Original languageEnglish
Pages (from-to)199-208
Number of pages10
JournalJournal of Minimal Access Surgery
Issue number3
Publication statusPublished - Jul 1 2016


  • Advanced gastric cancer (AGC)
  • distal gastrectomy
  • laparoscopy
  • meta-analysis
  • systematic review

ASJC Scopus subject areas

  • Surgery


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