Comparison of short-term outcomes between totally minimally invasive and minimally invasive-assisted Billroth-II gastrectomy for distal gastric cancer: A systematic review and meta-analysis.

INTRODUCTION

Minimally invasive Billroth-II distal gastrectomy is one of the most frequently recommended curative resections for patients with lower- and middle-third gastric cancer. However, the efficiency and benefits of totally minimally invasive and minimally invasive-assisted distal gastrectomy with Billroth-II anastomosis are still controversial. This meta-analysis was conducted to compare the short-term outcomes of the two surgical procedures.

PATIENTS AND

METHODS

We conducted an internet search of the PubMed, Web of Science, Cochrane Medline and Embase databases up to May 2023. The parameters related to surgical outcomes, post-operative recovery, post-operative complications and surgical stress response were subjected to subsequent statistical calculations. Review Manager 5.3 software was used to perform the meta-analysis.

RESULTS

A total of seven retrospective studies were included in this meta-analysis. No significant differences were observed in the operative time, number of anastomoses, number of retrieved lymph nodes or surgical stress response indices of white blood cells and C-reactive protein. We detected a lower estimated blood loss, a shorter incision, an earlier time to first flatus and a shorter post-operative hospital stay in patients who underwent totally minimally invasive Billroth-II distal gastrectomy.

CONCLUSION

Compared with minimally invasive-assisted Billroth-II distal gastrectomy, totally minimally invasive Billroth-II distal gastrectomy is a feasible and safe radical operation with acceptable surgical outcomes that may offer shorter post-operative recovery times.