Short-term outcomes in minimally invasive versus open gastrectomy: the differences between East and West. A systematic review of the literature

Nicole van der Wielen, Jennifer Straatman, Miguel A Cuesta, Freek Daams, Donald L van der Peet, Nicole van der Wielen, Jennifer Straatman, Miguel A Cuesta, Freek Daams, Donald L van der Peet

Abstract

Objective: Minimally invasive surgical techniques for gastric cancer are gaining more interest worldwide. Several Asian studies have proven the benefits of minimally invasive techniques over the open techniques. Nevertheless, implementation of this technique in Western countries is gradual. The aim of this systematic review is to give insight in the differences in outcomes and patient characteristics in Asian countries in comparison to Western countries.

Methodology: An extensive systematic search was conducted using the Medline, Embase, and Cochrane databases. Analysis of the outcomes was performed regarding operative results, postoperative recovery, complications, mortality, lymph node yield, radicality of the resected specimen, and survival. A total of 12 Asian and 8 Western studies were included.

Results: Minimally invasive gastrectomy shows faster postoperative recovery, fewer complications, and similar outcomes regarding mortality in both the Eastern and Western studies. However, patient characteristics such as age and BMI differ between these populations. Comparison of overall outcomes in minimally invasive and open procedures between East and West showed differences in complications, mortality, and number of resected lymph nodes in favor of the Asian population.

Conclusion: Improved outcomes are observed following minimally invasive gastrectomy in comparison to open procedures in both Western and Asian studies. There are differences in patient characteristics between the Western and Asian populations. Overall outcomes seem to be in favor of the Asian population. These differences may fade with centralization of care for gastric cancer patients in the West and increasing surgical experience.

Keywords: Gastrectomy; Gastric cancer; Minimally invasive.

Conflict of interest statement

Human and animal rights

This article does not contain any studies with human or animal subjects performed by any of the authors.

Conflict of interest

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Operation duration and blood loss
Fig. 2
Fig. 2
Hospital stay, time to first flatus, and time to first diet
Fig. 2
Fig. 2
Hospital stay, time to first flatus, and time to first diet
Fig. 3
Fig. 3
Postoperative complications and mortality
Fig. 4
Fig. 4
Lymph node yield

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