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Background . Some meta-analyses of case-controlled studies (CCSs) have shown that laparoscopic or laparoscopy-assisted total gastrectomy (LTG) had some short-term advantages over open total gastrectomy (OTG). However, postoperative complications differed somewhat among the meta-analyses, and some CCSs included in the meta-analyses had mismatched factors between LTG and OTG.  Methods . CCSs comparing postoperative complications between LTG and OTG were identified in PubMed and Embase. Studies matched for patients' status, tumor stage, and the extents of lymph-node dissection were included. Outcomes of interest, such as anastomotic, other intra-abdominal, wound, and pulmonary complications, were evaluated in a meta-analysis performed using Review Manager version 5.3 software.  Result . This meta-analysis included a total of 2,560 patients (LTG, 1,073 patients; OTG, 1,487 patients) from 15 CCSs. Wound complications were significantly less frequent in LTG than in OTG ( n  = 2,430; odds ratio [OR] 0.30, 95% confidence interval [CI] 0.29–0.85,  P  = 0.01,  I   2  = 0%, and OR 0.46, 95% CI 0.17–0.52,  P  < 0.0001,  I   2  = 0%). However, the incidence of anastomotic complications was slightly but not significantly higher in LTG than in OTG ( n  = 2,560; OR 1.44, 95% CI 0.96–2.16,  P  = 0.08,  I   2  = 0%).  Conclusion . LTG was associated with a lower incidence of wound-related postoperative complications than was OTG in this meta-analysis of CCSs; however, some concern remains about anastomotic problems associated with LTG.

gastroenterology research and practice

Postoperative Complications of Laparoscopic Total Gastrectomy versus Open Total Gastrectomy for Gastric Cancer in a Meta-Analysis of High-Quality Case-Controlled Studies