Evidence map›Paper›PMID 33080686›Full record

SynthesisMedicine2020

Is the 5-port approach necessary in laparoscopic gastrectomy? Comparison of surgical effects of reduced-port laparoscopic gastrectomy and conventional laparoscopic-assisted gastrectomy: A meta-analysis.

Hao Lai, Zhen Yi, Di Long, Jungang Liu, Haiquan Qin, Xianwei Mo, Huage Zhong, Yuan Lin, Zhao Li

Open access · goldAbstract readComparative StudyMeta-Analysis
In one paragraph

Synthesis in Medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 38% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Hao LaiDepartment of Gastrointestinal Surgery, Guangxi Cancer Hospital, 71 Hedi Road.
Zhen YiDepartment of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University.
Di LongDepartment of Gastrointestinal Surgery, Affiliated Wuming Hospital, Yongning Road.
Jungang LiuDepartment of Gastrointestinal Surgery, Guangxi Cancer Hospital, 71 Hedi Road.
Haiquan QinDepartment of Gastrointestinal Surgery, Guangxi Cancer Hospital, 71 Hedi Road.
Xianwei MoDepartment of Gastrointestinal Surgery, Guangxi Cancer Hospital, 71 Hedi Road.
Huage ZhongDepartment of Gastrointestinal Surgery, Guangxi Cancer Hospital, 71 Hedi Road.
Yuan LinDepartment of Gastrointestinal Surgery, Guangxi Cancer Hospital, 71 Hedi Road.
Zhao LiGuangxi Cancer Hospital, 71 Hedi Road, Nanning, Guangxi Autonomous Region, China.
Guangxi Medical University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundReduced-port surgery, in which fewer ports are used than those in conventional laparoscopic surgery, is becoming increasingly popular for various procedures. However, the application of reduced-port surgery to the gastrectomy field is still underdeveloped. The aim of this study was to use meta-analysis to address the potentially important advantages of this surgical technique.

methodsEmbase, PubMed, and Cochrane Library databases were systematically reviewed (through October 2019) to identify studies that compared reduced-port (RPLG) and conventional laparoscopic-assisted gastrectomy (CLG) in patients with gastric carcinoma. The endpoints were postoperative time, length of in-hospital stay, blood loss, retrieved lymph nodes, postoperative complications, time to first flatus, and aesthetic outcome.

resultsA total of 11 studies, which included 1743 patients (907 RPLG and 836 CLG), were ultimately included in this analysis. Better aesthetic results: were obtained with RPLG (risk ratio 1.578; 95%CI, 1.377-1.808; P = .000), although length of in-hospital stay (standard mean difference [SMD] -0.106; 95% CI, -0.222 to 0.010; P = .074), time to first flatus (SMD -0.006; 95%CI, -0.123 to 0.110; P = .913), and perioperative complications (risk ratio 0.255; 95%CI, 0.142-0.369; P = .478) were equivalent. However, operative time was significantly longer (SMD 0.301; 95%CI, 0.194-0.409; P = .00), blood loss was greater (SMD -0.31; 95%CI, -0.415 to 0.205; P = .000), and fewer lymph nodes were harvested (SMD 0.255; 95%CI, 0.142-0.369; P = .000) in the RPLG group.

conclusionsOur meta-analysis showed that RPLG is as safe as the CLG approach and offers better aesthetic results for patients with gastric carcinoma. However, basing on current evidence, RPLG was not an efficacious surgical alternative to CLG, as operative time was significantly longer, blood loss was greater, and fewer lymph nodes were harvested in the RPLG group. Additional high-powered controlled randomized trials are required, to determine whether RPLG truly offers any advantages; these future studies should particularly focus on pain scores and aesthetic outcomes.

Indexed as

Blood Loss, SurgicalGastrectomyHumansLaparoscopyLength of StayLymph Node ExcisionOperative TimePostoperative ComplicationsStomach Neoplasms

Identifiers

PMID33080686
PMCPMC7571981
OpenAlexW3094455897

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.